Healthcare Provider Details

I. General information

NPI: 1982012449
Provider Name (Legal Business Name): JANICE JARAMILLO C-PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANICE LOPEZ C-PNP

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1193 W 49TH ST
HIALEAH FL
33012-3337
US

IV. Provider business mailing address

1601 NW 12TH AVE
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-777-9190
  • Fax: 305-779-0729
Mailing address:
  • Phone: 305-243-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9453730
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF382451-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9453730
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number9453730
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: