Healthcare Provider Details

I. General information

NPI: 1205793718
Provider Name (Legal Business Name): JOHANNA VASQUEZ - SOLIS PITA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 NE 2ND AVE
MIAMI FL
33137-3441
US

IV. Provider business mailing address

3880 BIRD RD APT 422
CORAL GABLES FL
33146-1540
US

V. Phone/Fax

Practice location:
  • Phone: 305-905-9985
  • Fax:
Mailing address:
  • Phone: 305-905-9985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11044482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: