Healthcare Provider Details

I. General information

NPI: 1063840379
Provider Name (Legal Business Name): KRISTEN MARIE NIEVES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2013
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7887 N KENDALL DR SUITE 101
MIAMI FL
33156-7427
US

IV. Provider business mailing address

7887 N KENDALL DR SUITE 101
MIAMI FL
33156-7427
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-6266
  • Fax: 305-273-6520
Mailing address:
  • Phone: 305-273-6266
  • Fax: 305-273-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9266557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: