Healthcare Provider Details

I. General information

NPI: 1780570614
Provider Name (Legal Business Name): GILLIAN CARMENATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BISCAYNE BLVD STE 400
MIAMI FL
33131-4324
US

IV. Provider business mailing address

201 S BISCAYNE BLVD STE 400
MIAMI FL
33131-4324
US

V. Phone/Fax

Practice location:
  • Phone: 305-374-4143
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11039094
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: