Healthcare Provider Details

I. General information

NPI: 1164054847
Provider Name (Legal Business Name): ARLINE REGALADO SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 W 23RD ST
HIALEAH FL
33010-2211
US

IV. Provider business mailing address

13278 NW 10TH ST
MIAMI FL
33182-2239
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-3312
  • Fax:
Mailing address:
  • Phone: 786-731-4208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11006034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: