MEDICARE: ADRIAN GAINZA A.R.N.P

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	363LA2200X	Adult Health Nurse Practitioner	ARNP 9249683	FL

General Provider Information

NPI Number	:	1912201914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN GAINZA A.R.N.P

Provider Business Mailing Address
First Line	:	1456 SW 155TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33194-2625
Country	:	US
Telephone Number	:	305-227-6605
Fax Number	:

Provider Business Practice Location Address
First Line	:	1456 SW 155TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33194-2625
Country	:	US
Telephone Number	:	305-227-6605
Fax Number	:

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

Provider Enumeration Date	:	01/05/2011
Last Update Date	:	01/05/2011

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