Healthcare Provider Details

I. General information

NPI: 1578136008
Provider Name (Legal Business Name): RONALD WARD MEGRET APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15495 EAGLE NEST LN STE 225
MIAMI LAKES FL
33014-2265
US

IV. Provider business mailing address

3531 W 73RD TER
HIALEAH GARDENS FL
33018-1715
US

V. Phone/Fax

Practice location:
  • Phone: 305-828-3214
  • Fax:
Mailing address:
  • Phone: 786-468-4871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11011622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: