Healthcare Provider Details

I. General information

NPI: 1306345384
Provider Name (Legal Business Name): ASHLEY MILIAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY GUTIERREZ APRN

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE STE 130
HOLLYWOOD FL
33021-5424
US

IV. Provider business mailing address

2900 CORPORATE WAY DOOR D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-7700
  • Fax: 954-265-7700
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9383996
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: