Healthcare Provider Details
I. General information
NPI: 1831600451
Provider Name (Legal Business Name): MARIA CECILIA BOTERO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/23/2017
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1120 NW 14TH ST
MIAMI FL
33136-2107
US
IV. Provider business mailing address
1255 PENNSYLVANIA AVE APT 107
MIAMI BEACH FL
33139-4497
US
V. Phone/Fax
- Phone: 305-243-2279
- Fax: 305-243-8108
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 9351455 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN9351455 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: