Healthcare Provider Details

I. General information

NPI: 1740635150
Provider Name (Legal Business Name): DONNA MICHELLE TRIM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136
US

IV. Provider business mailing address

301 NW 177ST #214
MIAMI GARDENS FL
33169
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5109
  • Fax:
Mailing address:
  • Phone: 305-917-5985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9251040
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: