Most Relevant Information
Provider Data
| NPI Number: | 1003479189 |
| Provider Name: | STEPHANIE VIETINGHOFF MSN AGACNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 11001436 |
Most Important Dates
| Enumeration Date: | 04/15/2019 |
| Last Updated: | 04/15/2019 |
Provider Practice Location
5000 W OAKLAND PARK BLVD
LAUDERDALE LAKES
FL
333131585
Practice Location Phone/Fax
| Phone: | 9547356000 |
| Fax: |
Provider Mailing Location
8551 NW 46TH CT
LAUDERHILL
FL
333515424
Provider Mailing Phone/Fax
| Phone: | 9548738760 |
| Fax: |