Healthcare Provider Details

I. General information

NPI: 1326747171
Provider Name (Legal Business Name): NICOLE ARENCIBIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 103
MIAMI FL
33176-2131
US

IV. Provider business mailing address

2100 SW 145TH AVE
MIAMI FL
33175-7477
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-4013
  • Fax:
Mailing address:
  • Phone: 305-322-7830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9274178
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN11031231
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: