ELLEN CAROL AXINN (NPI# 1861509218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861509218 |
| Entity Type | Individual |
| Full Name | ELLEN CAROL AXINN |
| Credential | ARNP |
| Practice Address |
1005 Joe Dimaggio Drive 4 Central Hollywood FL 33021 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542651482 |
| Mailing Telephone | (954) 276-5685 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
1360012 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4651 Sheridan Street, Hollywood, FL 33021 | 9542651482 |
| Street Address |
1005 JOE DIMAGGIO DRIVE 4 CENTRAL |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912526252 | Jessica Elaine Simpson | Student in an Organized Health Care Education/Training Program | 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2020-04-15 |
| 1841676947 | Marlene Fayette-cowgill | Audiologist | 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2015-07-31 |
| 1235423062 | Sheridan Healthcorp, Inc | Nurse Anesthetist, Certified Registered | 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2011-06-09 |
| 1003108077 | Lauren K. Grodin | Psychologist | 1005 Joe Dimaggio Drive, Pediatric Heart Station, Hollywood, FL 33021 | 2011-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366953242 | Summer Lynn Divincenzo | Nurse Practitioner | 4430 Sheridan St Ste B, Hollywood, FL 33021-3546 | 2017-10-18 |
| 1902914153 | Karen Fleuridor | Nurse Practitioner | 4651 Sheridan St Ste 150, Hollywood, FL 33021-3443 | 2006-08-28 |
| 1851916282 | Porsha St Pierre | Nurse Practitioner | 3501 Johnson St, Hollywood, FL 33021-5421 | 2020-06-11 |
| 1023505658 | Crystal Ann Onori | Nurse Practitioner | 1150 N 35th Ave Ste 555, Hollywood, FL 33021-5431 | 2018-04-19 |
| 1124536776 | Amanda R Grieco | Nurse Practitioner | 1131 N 35th Ave Fl 2, Hollywood, FL 33021-5403 | 2018-01-17 |
| 1700393386 | Elizabeth Ann Cross | Nurse Practitioner | 4500 Sheridan St, Hollywood, FL 33021-3516 | 2018-01-04 |
| 1891200085 | Lizette Caballero | Nurse Practitioner | 1131 N 35th Ave Ste 200, Hollywood, FL 33021 | 2017-12-10 |
| 1629583364 | Megan Rivers Rodriguez | Nurse Practitioner | 1150 N 35th Ave Ste 490, Hollywood, FL 33021-5423 | 2017-12-04 |
| 1407361199 | Martine Ramjohn | Nurse Practitioner | 4651 Sheridan St Ste 150, Hollywood, FL 33021 | 2017-12-04 |
| 1376070672 | Angela Maria Otero | Nurse Practitioner | 4500 Sheridan St, Hollywood, FL 33021-3516 | 2017-05-17 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.