Healthcare Provider Details

I. General information

NPI: 1801218474
Provider Name (Legal Business Name): ENRIQUE MASPONS ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 09/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8850 NW 122ND ST
HIALEAH GARDENS FL
33018-1748
US

IV. Provider business mailing address

16585 SW 44TH LN
MIAMI FL
33185-3897
US

V. Phone/Fax

Practice location:
  • Phone: 305-351-7181
  • Fax: 305-424-5580
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9266717
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9266717
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: