Healthcare Provider Details

I. General information

NPI: 1710375324
Provider Name (Legal Business Name): AVERETTE JOSEPH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 01/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 NW 9TH AVE SUITE 1700
MIAMI FL
33136-1409
US

IV. Provider business mailing address

6193 NW 183RD ST 171426
HIALEAH FL
33017-0547
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-7248
  • Fax: 305-355-7244
Mailing address:
  • Phone: 305-355-7777
  • Fax: 305-355-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2517782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: