Healthcare Provider Details

I. General information

NPI: 1215848619
Provider Name (Legal Business Name): ELSA MORA ARNP.FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10631 W 34TH CT
HIALEAH FL
33018-2122
US

IV. Provider business mailing address

10631 W 34TH CT
HIALEAH FL
33018-2122
US

V. Phone/Fax

Practice location:
  • Phone: 305-986-8306
  • Fax:
Mailing address:
  • Phone: 305-986-8306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11050859
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: