Healthcare Provider Details

I. General information

NPI: 1922910140
Provider Name (Legal Business Name): JENNI SALAS BOTERO DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11711 SW 92ND TER
MIAMI FL
33186-2153
US

IV. Provider business mailing address

11711 SW 92ND TER
MIAMI FL
33186-2153
US

V. Phone/Fax

Practice location:
  • Phone: 786-877-4148
  • Fax:
Mailing address:
  • Phone: 786-877-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRN9567189
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN9567189
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: