Provider Demographics
NPI:1396461760
Name:NAIR, PRIYA SIVAKUMAR
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:SIVAKUMAR
Last Name:NAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-4330
Mailing Address - Country:US
Mailing Address - Phone:301-980-1133
Mailing Address - Fax:
Practice Address - Street 1:5204 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-4330
Practice Address - Country:US
Practice Address - Phone:301-980-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9361867163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN600-677-72-010-0OtherDRIVERS LISENCE