Provider Demographics
NPI:1730168568
Name:NOGAH BITTNER, LEIGH (APRN)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:NOGAH BITTNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:NOGAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1613 NORTH HARRISON PARKWAY
Mailing Address - Street 2:BLDG C-SUITE #200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2864
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:3100 WESTON ROAD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3602
Practice Address - Country:US
Practice Address - Phone:954-689-5000
Practice Address - Fax:954-659-6047
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP16721751363L00000X
FLARNP1751672363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS56445Medicare UPIN
FLY7148AMedicare ID - Type Unspecified