Healthcare Provider Details

I. General information

NPI: 1104432756
Provider Name (Legal Business Name): JENNIFER ALFAFARA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 W CAMELBACK RD STE 136
PHOENIX AZ
85037-1364
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-8906
  • Fax:
Mailing address:
  • Phone: 305-500-2000
  • Fax: 786-522-9018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5021998
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number247874
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: