Healthcare Provider Details

I. General information

NPI: 1528570512
Provider Name (Legal Business Name): BARBARA CERDEIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 SW 12TH AVE STE 100
MIAMI FL
33130-2431
US

IV. Provider business mailing address

13228 NW 11TH ST
MIAMI FL
33182-2247
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-2929
  • Fax:
Mailing address:
  • Phone: 786-301-5378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9292566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: