Healthcare Provider Details

I. General information

NPI: 1356201933
Provider Name (Legal Business Name): HANNY MARI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 W 20TH AVE STE 101
HIALEAH FL
33016-1813
US

IV. Provider business mailing address

1 MAIN ST APT 831
MIRAMAR FL
33025-8239
US

V. Phone/Fax

Practice location:
  • Phone: 305-822-0401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11043686
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11043686
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: