Healthcare Provider Details

I. General information

NPI: 1538273677
Provider Name (Legal Business Name): ROXANNE CARRIE CESPEDES A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NW 12TH AVE SUITE 711-E
MIAMI FL
33136-1051
US

IV. Provider business mailing address

1845 SW 118TH CT # 84
MIAMI FL
33175-8739
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5513
  • Fax: 305-585-0076
Mailing address:
  • Phone: 305-553-3357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1460662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: