Healthcare Provider Details

I. General information

NPI: 1407126857
Provider Name (Legal Business Name): LAUREN DANIELLE VIEGO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2012
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 N KENDALL DR FL 2
MIAMI FL
33176-1437
US

IV. Provider business mailing address

14621 BALGOWAN RD APT 202
MIAMI LAKES FL
33016-6467
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-7999
  • Fax:
Mailing address:
  • Phone: 305-582-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9259575
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: