Healthcare Provider Details

I. General information

NPI: 1396991915
Provider Name (Legal Business Name): GRETEL PEON VINENT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date: 04/15/2022
Reactivation Date: 06/02/2022

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03220663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: