Healthcare Provider Details

I. General information

NPI: 1285172114
Provider Name (Legal Business Name): NAHOMIE MIRVILLE DNP,FNP-BC, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2017
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON ST STE 104
HOLLYWOOD FL
33021-8291
US

IV. Provider business mailing address

3700 WASHINGTON ST STE 104
HOLLYWOOD FL
33021-8291
US

V. Phone/Fax

Practice location:
  • Phone: 305-836-1090
  • Fax: 305-836-1199
Mailing address:
  • Phone: 305-836-1090
  • Fax: 305-836-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9225337
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: