Healthcare Provider Details

I. General information

NPI: 1801624176
Provider Name (Legal Business Name): DIRIAM IRIARTE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 BAPTIST WAY STE 103
HOMESTEAD FL
33033-7600
US

IV. Provider business mailing address

14012 SW 260TH ST APT 104
HOMESTEAD FL
33032-6652
US

V. Phone/Fax

Practice location:
  • Phone: 305-245-4549
  • Fax: 305-245-4590
Mailing address:
  • Phone: 786-817-4751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11034278
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: