Healthcare Provider Details

I. General information

NPI: 1477417400
Provider Name (Legal Business Name): MILAGRO MAGALYS MOREJON VALERO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9995 SUNSET DR STE 205
MIAMI FL
33173-4662
US

IV. Provider business mailing address

12930 NW 8TH ST
MIAMI FL
33182-2369
US

V. Phone/Fax

Practice location:
  • Phone: 786-401-7528
  • Fax:
Mailing address:
  • Phone: 786-925-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11043901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: