MEDICARE: SUSANA PRECIADO ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN11007501	FL

General Provider Information

NPI Number	:	1144848789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSANA PRECIADO ARNP

Provider Business Mailing Address
First Line	:	13747 SW 30TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6606
Country	:	US
Telephone Number	:	786-237-4845
Fax Number	:

Provider Business Practice Location Address
First Line	:	13747 SW 30TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6606
Country	:	US
Telephone Number	:	786-237-4845
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2020
Last Update Date	:	07/09/2020

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