Healthcare Provider Details

I. General information

NPI: 1366105264
Provider Name (Legal Business Name): MONICA ALMIRALL PALENZUELA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1101 MARSEILLE DR APT 102
MIAMI BEACH FL
33141-2842
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6407
  • Fax: 305-243-2918
Mailing address:
  • Phone: 954-952-2469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11015949
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: