Healthcare Provider Details
I. General information
NPI: 1972924819
Provider Name (Legal Business Name): JAYLER VALDES HECHEVARRIA ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/19/2013
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
149 W 21ST ST
HIALEAH FL
33010-2615
US
IV. Provider business mailing address
11255 SW 211TH ST AMERICAN CARE OF SOUTH FLORIDA, INC.
MIAMI FL
33189-2240
US
V. Phone/Fax
- Phone: 305-558-0765
- Fax: 786-219-4355
- Phone: 305-278-0200
- Fax: 786-235-0145
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | ARNP-9338953 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: