Healthcare Provider Details

I. General information

NPI: 1699452755
Provider Name (Legal Business Name): AMARACHUKWU OKOROAFOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SW 37TH AVE APT 603
COCONUT GROVE FL
33133-2770
US

IV. Provider business mailing address

2650 SW 37TH AVE APT 603
COCONUT GROVE FL
33133-2770
US

V. Phone/Fax

Practice location:
  • Phone: 301-395-9530
  • Fax:
Mailing address:
  • Phone: 301-395-9530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9607654
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC007246
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: