Healthcare Provider Details

I. General information

NPI: 1275080558
Provider Name (Legal Business Name): HECTOR RICARDO PAYARES ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 NW 53RD ST
DORAL FL
33166-4653
US

IV. Provider business mailing address

7950 NW 53RD ST
DORAL FL
33166-4653
US

V. Phone/Fax

Practice location:
  • Phone: 645-214-4575
  • Fax: 786-289-9420
Mailing address:
  • Phone: 645-214-4575
  • Fax: 786-289-9420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number9241803
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9241803
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9241803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: