Healthcare Provider Details

I. General information

NPI: 1427564533
Provider Name (Legal Business Name): ISAIRIS ARECHAVALETA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 07/28/2026
Certification Date: 01/26/2021
Deactivation Date: 10/31/2025
Reactivation Date: 07/28/2026

III. Provider practice location address

22411 SW 102ND AVE
MIAMI FL
33190-1019
US

IV. Provider business mailing address

22411 SW 102ND AVE
MIAMI FL
33190-1019
US

V. Phone/Fax

Practice location:
  • Phone: 786-457-0503
  • Fax:
Mailing address:
  • Phone: 786-457-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9346538
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9346538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: