Healthcare Provider Details

I. General information

NPI: 1831992726
Provider Name (Legal Business Name): ANNY ROSELYNN MORALES SOUQUETT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 NW 95TH AVE UNIT 2
DORAL FL
33172-2339
US

IV. Provider business mailing address

9744 NW 46TH TER
DORAL FL
33178-1982
US

V. Phone/Fax

Practice location:
  • Phone: 305-553-8033
  • Fax:
Mailing address:
  • Phone: 305-833-6576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11038461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: