Healthcare Provider Details

I. General information

NPI: 1578306171
Provider Name (Legal Business Name): KEILA INES PREWITT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12294 INDIAN ROCKS RD
LARGO FL
33774-3001
US

IV. Provider business mailing address

1000 NW 57TH CT STE 400
MIAMI FL
33126-3292
US

V. Phone/Fax

Practice location:
  • Phone: 727-595-2534
  • Fax: 727-593-1773
Mailing address:
  • Phone: 786-758-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11033358
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: