Provider Demographics
NPI:1295327914
Name:NORRIS, NEVADA (PA-C)
Entity type:Individual
Prefix:
First Name:NEVADA
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 NE 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2937
Mailing Address - Country:US
Mailing Address - Phone:813-597-5511
Mailing Address - Fax:
Practice Address - Street 1:1801 NE 123RD ST STE 417
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2885
Practice Address - Country:US
Practice Address - Phone:813-597-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant