Healthcare Provider Details

I. General information

NPI: 1962895375
Provider Name (Legal Business Name): VIVIANA MELISSA RUA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIVIANA MELISSA GONZALEZ ARNP

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 05/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVENUE
MIAMI FL
33155
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-6511
  • Fax:
Mailing address:
  • Phone: 305-662-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9310213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: