Provider Demographics
NPI:1013639525
Name:CERTI-FI NP PLLC
Entity type:Organization
Organization Name:CERTI-FI NP PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MSN, FNP-BC, AGACNP-BC / TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP-BC, AGACNP
Authorized Official - Phone:786-679-5825
Mailing Address - Street 1:3174 NW FEDERAL HWY # 3490
Mailing Address - Street 2:SUITE 302-303
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957
Mailing Address - Country:US
Mailing Address - Phone:954-298-2823
Mailing Address - Fax:800-860-1168
Practice Address - Street 1:3174 NW FEDERAL HWY # 3490
Practice Address - Street 2:SUITE 302-303
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957
Practice Address - Country:US
Practice Address - Phone:954-298-2823
Practice Address - Fax:800-860-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9247990OtherLICENSE NUMBER
FL116451500Medicaid