Basic Information
| Provider Information | |||||||||
| NPI: | 1952603052 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALTIMARI | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RN NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2951 NW 49TH AVE | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333131600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547337606 | ||||||||
| FaxNumber: | 9547337650 | ||||||||
| Practice Location | |||||||||
| Address1: | 2951 NW 49TH AVE | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333131600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547337606 | ||||||||
| FaxNumber: | 9547337650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2010 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP2840092 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.