Healthcare Provider Details

I. General information

NPI: 1679043566
Provider Name (Legal Business Name): MARIANA CRISTINA O'NEILL APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 W 20TH AVE STE 612
HIALEAH FL
33016-5534
US

IV. Provider business mailing address

4500 SW 68TH COURT CIR APT 9
MIAMI FL
33155-6810
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-1561
  • Fax:
Mailing address:
  • Phone: 305-281-1839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11000403
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: