Healthcare Provider Details

I. General information

NPI: 1457238065
Provider Name (Legal Business Name): VANESSA REILA ZUMARRAGA MSN, RN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6218 SW 131ST PL APT 101
MIAMI FL
33183-5267
US

IV. Provider business mailing address

6218 SW 131ST PL APT 101
MIAMI FL
33183-5267
US

V. Phone/Fax

Practice location:
  • Phone: 786-218-1315
  • Fax:
Mailing address:
  • Phone: 786-218-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11041735
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: