Healthcare Provider Details

I. General information

NPI: 1578409520
Provider Name (Legal Business Name): INES MARIA TAMAYO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9903 NW 9TH STREET CIR
MIAMI FL
33172-5105
US

IV. Provider business mailing address

9903 NW 9TH STREET CIR
MIAMI FL
33172-5105
US

V. Phone/Fax

Practice location:
  • Phone: 786-315-8625
  • Fax: 786-315-8625
Mailing address:
  • Phone: 786-315-8625
  • Fax: 786-315-8625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11046560
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: