Healthcare Provider Details

I. General information

NPI: 1003308685
Provider Name (Legal Business Name): JOSE R JIRON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 NW 14TH ST STE 510
MIAMI FL
33125-1659
US

IV. Provider business mailing address

11760 SW 14TH ST
MIAMI FL
33184-2513
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-5554
  • Fax: 305-243-1731
Mailing address:
  • Phone: 305-979-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9335476
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: