Healthcare Provider Details

I. General information

NPI: 1497177869
Provider Name (Legal Business Name): ABIGAIL MERCHESA PHILLIPS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2014
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8761 SW 204TH LN
CUTLER BAY FL
33189-2165
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-1960
  • Fax:
Mailing address:
  • Phone: 305-283-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9177133
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: