Healthcare Provider Details

I. General information

NPI: 1124296801
Provider Name (Legal Business Name): ARMANDO IZQUIERDO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8837 NW 151ST TER
MIAMI LAKES FL
33018-1337
US

IV. Provider business mailing address

8837 NW 151ST TER
MIAMI LAKES FL
33018-1337
US

V. Phone/Fax

Practice location:
  • Phone: 786-427-5866
  • Fax:
Mailing address:
  • Phone: 786-427-5866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number07-289
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022836
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: