Healthcare Provider Details

I. General information

NPI: 1336874882
Provider Name (Legal Business Name): DEYSI LARRAMENDI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD STE 2522
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

4300 ALTON RD STE 2522
MIAMI BEACH FL
33140-2948
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2240
  • Fax:
Mailing address:
  • Phone: 305-674-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11017545
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: