Healthcare Provider Details

I. General information

NPI: 1528523644
Provider Name (Legal Business Name): JANETTE VIERA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2019
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 SW 112TH ST # A
MIAMI FL
33186-4768
US

IV. Provider business mailing address

12955 SW 112TH ST # A
MIAMI FL
33186-4768
US

V. Phone/Fax

Practice location:
  • Phone: 305-382-4161
  • Fax:
Mailing address:
  • Phone: 305-382-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9400466
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9400466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: