BLACKSHEEP MEDICINE LLC NPI 1467236877

NPI Information

NPI: 1467236877
Provider Name: BLACKSHEEP MEDICINE LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
1120 LEXINGTON GREEN LN STE A
SANFORD, FL
ZIP 32771
Phone: (407) 900-1394
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BLACKSHEEP MEDICINE LLC is a family nurse practitioner in Sanford, FL. BLACKSHEEP MEDICINE LLC NPI is 1467236877. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1120 LEXINGTON GREEN LN STE A
SANFORD, FL
ZIP 32771-022
Phone: (407) 900-1394

The provider's authorized official is Whitney Charisma .
The authorized official title is Owner / Provider and has the following contact phone number (407) 900-1394.

The enumeration date for this NPI number is 8/24/2023 and was last updated on 8/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	103694100	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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