Healthcare Provider Details

I. General information

NPI: 1528024205
Provider Name (Legal Business Name): CORINNE I KIRKLAND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11440 SW 88TH ST SUITE 109
MIAMI FL
33176-1044
US

IV. Provider business mailing address

1345 WEST AVE 701
MIAMI BEACH FL
33139-3759
US

V. Phone/Fax

Practice location:
  • Phone: 786-263-0001
  • Fax: 786-263-0004
Mailing address:
  • Phone: 305-672-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number937152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: