Healthcare Provider Details

I. General information

NPI: 1740691526
Provider Name (Legal Business Name): FABIOLA NOEL RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

IV. Provider business mailing address

1175 NW 155TH LN APT 201
MIAMI FL
33169-6327
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-7000
  • Fax: 305-575-3437
Mailing address:
  • Phone: 786-838-1279
  • Fax: 305-953-1055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number13117
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: