Healthcare Provider Details

I. General information

NPI: 1720566599
Provider Name (Legal Business Name): MABEL DI MARE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9732 SW 24TH ST
MIAMI FL
33165-7513
US

IV. Provider business mailing address

10975 SW 174TH TER
MIAMI FL
33157-4063
US

V. Phone/Fax

Practice location:
  • Phone: 305-221-0660
  • Fax: 305-221-0696
Mailing address:
  • Phone: 786-389-4156
  • Fax: 305-964-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9233005
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: