Healthcare Provider Details

I. General information

NPI: 1780469759
Provider Name (Legal Business Name): PRISCILLA MERCY JUNCADELLA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W FLAGLER ST
CORAL GABLES FL
33134-1604
US

IV. Provider business mailing address

2300 NW 89TH PL FL 3
DORAL FL
33172-2431
US

V. Phone/Fax

Practice location:
  • Phone: 305-774-3600
  • Fax:
Mailing address:
  • Phone: 305-398-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11028325
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: