Healthcare Provider Details

I. General information

NPI: 1205553799
Provider Name (Legal Business Name): KENIA MERCEDES ESCOTO RODRIGUEZ ARNP FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10824 SW 2ND ST APT 115
MIAMI FL
33174-1499
US

IV. Provider business mailing address

10824 SW 2ND ST APT 115
MIAMI FL
33174-1499
US

V. Phone/Fax

Practice location:
  • Phone: 786-587-6438
  • Fax:
Mailing address:
  • Phone: 786-587-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11022454
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: