Healthcare Provider Details

I. General information

NPI: 1114743903
Provider Name (Legal Business Name): ARIANNA FERNANDEZ DE VEGAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIANNA FERNANDEZ MSN PMHNP BC, FNP C

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 37TH AVE STE 903
MIAMI FL
33133-2751
US

IV. Provider business mailing address

6021 W 14TH CT
HIALEAH FL
33012-6246
US

V. Phone/Fax

Practice location:
  • Phone: 305-204-9799
  • Fax:
Mailing address:
  • Phone: 786-727-5317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9509582
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11036738
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11036738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: