Healthcare Provider Details

I. General information

NPI: 1336071307
Provider Name (Legal Business Name): JESSICA MARIA PLACERES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341 SW 99TH CT
MIAMI FL
33165-5012
US

IV. Provider business mailing address

4341 SW 99TH CT
MIAMI FL
33165-5012
US

V. Phone/Fax

Practice location:
  • Phone: 305-801-0444
  • Fax:
Mailing address:
  • Phone: 305-801-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number9623729
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: