Healthcare Provider Details

I. General information

NPI: 1811551880
Provider Name (Legal Business Name): SOLEDAD HERRERA ESTUPINAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E 3RD ST STE 202
HIALEAH FL
33010-4973
US

IV. Provider business mailing address

5200 NE 2ND AVE
MIAMI FL
33137-2706
US

V. Phone/Fax

Practice location:
  • Phone: 786-347-2040
  • Fax:
Mailing address:
  • Phone: 305-751-8626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11001026
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: