Healthcare Provider Details

I. General information

NPI: 1528316015
Provider Name (Legal Business Name): DENISE ANDREA DIXON RN-ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 CRANDON BLVD
KEY BISCAYNE FL
33149-2506
US

IV. Provider business mailing address

3148 NW 196TH ST
MIAMI GARDENS FL
33056-2456
US

V. Phone/Fax

Practice location:
  • Phone: 186-638-9272
  • Fax:
Mailing address:
  • Phone: 305-607-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9200121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: