Provider Demographics
NPI:1316261209
Name:BIVINS, BALKYS LAMERCIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:BALKYS
Middle Name:LAMERCIE
Last Name:BIVINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12651 W SUNRISE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-0906
Mailing Address - Country:US
Mailing Address - Phone:984-887-0951
Mailing Address - Fax:954-653-8669
Practice Address - Street 1:12651 W SUNRISE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-0906
Practice Address - Country:US
Practice Address - Phone:984-887-0951
Practice Address - Fax:954-653-8669
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2577492363LP0808X
FL2577492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily