Healthcare Provider Details

I. General information

NPI: 1427896729
Provider Name (Legal Business Name): JENNIFER CERVANTES APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 SW 37TH AVE STE 502
CORAL GABLES FL
33133-2744
US

IV. Provider business mailing address

14501 SW 138TH CT
MIAMI FL
33186-7280
US

V. Phone/Fax

Practice location:
  • Phone: 305-448-8134
  • Fax:
Mailing address:
  • Phone: 786-319-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11033842
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: