Provider Demographics
NPI:1881337202
Name:DR. MOMPRENUER LLC
Entity type:Organization
Organization Name:DR. MOMPRENUER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CADENHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-733-3691
Mailing Address - Street 1:5155 NW 87TH TER
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4879
Mailing Address - Country:US
Mailing Address - Phone:305-733-3691
Mailing Address - Fax:
Practice Address - Street 1:5155 NW 87TH TER
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4879
Practice Address - Country:US
Practice Address - Phone:305-733-3691
Practice Address - Fax:954-904-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty