MEDICARE: LIUDMILA PARGA IBANEZ APRN

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	11016402	FL

General Provider Information

NPI Number	:	1629736335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIUDMILA PARGA IBANEZ APRN

Provider Business Mailing Address
First Line	:	111 NW 183RD ST STE 204
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-4578
Country	:	US
Telephone Number	:	305-655-0702
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 NW 183RD ST STE 204
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-4578
Country	:	US
Telephone Number	:	305-655-0702
Fax Number	:

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

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	07/08/2025

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