Provider Demographics
NPI:1386332765
Name:CONCIERGE APRN
Entity type:Organization
Organization Name:CONCIERGE APRN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:TIFERET
Authorized Official - Last Name:AZARI-GARMIZO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, AGACNP-BC
Authorized Official - Phone:786-280-7892
Mailing Address - Street 1:9048 CARLYLE AVE
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3240
Mailing Address - Country:US
Mailing Address - Phone:786-280-7892
Mailing Address - Fax:
Practice Address - Street 1:9048 CARLYLE AVE
Practice Address - Street 2:
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-3240
Practice Address - Country:US
Practice Address - Phone:786-280-7892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service