Active NPI
Lydia Bridgewater
- Licensed Practical Nurse
- Coral Springs, FL
National Provider Identifier
1023219615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN 1289621
- Practice address
- 990 Coral Ridge Dr
Apt 103
Coral Springs, FL 33071-4169 - Phone
- (954) 993-5478
- NPI assigned
- May 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN 1289621 | FL | Primary |
Addresses
Primary practice location
990 Coral Ridge Dr
Apt 103
Coral Springs, FL 33071-4169
Mailing address
990 Coral Ridge Dr
Apt 103
Coral Springs, FL 33071-4169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN 1289621 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023219615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 CORAL RIDGE DR",
"address_2": "APT 103",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330714169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 CORAL RIDGE DR",
"address_2": "APT 103",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330714169",
"telephone_number": "954-993-5478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGEWATER",
"first_name": "LYDIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN 1289621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.