Healthcare Provider Details

I. General information

NPI: 1124665906
Provider Name (Legal Business Name): NATALIE URBANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2019
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 742057
ATLANTA GA
30374-2057
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-2000
  • Fax:
Mailing address:
  • Phone: 786-596-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9112541
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: