Healthcare Provider Details

I. General information

NPI: 1184254484
Provider Name (Legal Business Name): MITZY MARGARITA BUENO GARCIA MERAS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2020
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 W 46TH PL
HIALEAH FL
33012-3864
US

IV. Provider business mailing address

481 W 46TH PL
HIALEAH FL
33012-3864
US

V. Phone/Fax

Practice location:
  • Phone: 786-326-4734
  • Fax:
Mailing address:
  • Phone: 786-326-4734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberAPRN11003850
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9431677
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11003850
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: