Healthcare Provider Details

I. General information

NPI: 1386565679
Provider Name (Legal Business Name): JANY CORRIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20421 NW 20TH CT
MIAMI GARDENS FL
33056-1610
US

IV. Provider business mailing address

20421 NW 20TH CT
MIAMI GARDENS FL
33056-1610
US

V. Phone/Fax

Practice location:
  • Phone: 786-619-5822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberAPRN11049435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: