MEDICARE: NILDA MUDARRA RRT

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	2279P1004X	Pulmonary Diagnostics Registered Respiratory Therapist
2	2279P1005X	Pulmonary Rehabilitation Registered Respiratory Therapist
3	2279H0200X	Home Health Registered Respiratory Therapist	RT9656	FL
4	2279E1000X	Educational Registered Respiratory Therapist
5	227900000X	Registered Respiratory Therapist

General Provider Information

NPI Number	:	1184518086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NILDA MUDARRA RRT

Provider Business Mailing Address
First Line	:	8731 SW 192ND TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-8954
Country	:	US
Telephone Number	:	786-909-8463
Fax Number	:	305-723-2777

Provider Business Practice Location Address
First Line	:	8731 SW 192ND TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-8954
Country	:	US
Telephone Number	:	786-389-8813
Fax Number	:	305-723-2777

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

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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