Healthcare Provider Details

I. General information

NPI: 1427881374
Provider Name (Legal Business Name): BUXADERA NURSE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10540 SW 30TH ST
MIAMI FL
33165-2762
US

IV. Provider business mailing address

10540 SW 30TH ST
MIAMI FL
33165-2762
US

V. Phone/Fax

Practice location:
  • Phone: 786-202-5438
  • Fax:
Mailing address:
  • Phone: 786-202-5438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SILVIA VILLAVICENCIO
Title or Position: OWNER
Credential:
Phone: 786-262-5438