Healthcare Provider Details

I. General information

NPI: 1598628026
Provider Name (Legal Business Name): MIRACLE VICTORIA ARCEUS DNP APRN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17381 NW 7TH AVE APT 103
MIAMI FL
33169-7086
US

IV. Provider business mailing address

17381 NW 7TH AVE APT 103
MIAMI FL
33169-7086
US

V. Phone/Fax

Practice location:
  • Phone: 305-795-0049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11043976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: