Provider Demographics
NPI:1134748106
Name:VICTOR, STEPHANIE FRANCINE (APRN-BC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FRANCINE
Last Name:VICTOR
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20448 NW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2390
Mailing Address - Country:US
Mailing Address - Phone:786-423-6065
Mailing Address - Fax:
Practice Address - Street 1:20448 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2390
Practice Address - Country:US
Practice Address - Phone:786-423-6065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9239480363LF0000X
FLAPRN9239480363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily