Healthcare Provider Details

I. General information

NPI: 1972263093
Provider Name (Legal Business Name): YUDITH ESPANA MONTES DE OCA APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST # 450
MIAMI FL
33136-2107
US

IV. Provider business mailing address

6240 NW 40TH ST
VIRGINIA GARDENS FL
33166-7064
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-4902
  • Fax: 305-243-4907
Mailing address:
  • Phone: 786-290-3735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11016508
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: