Healthcare Provider Details

I. General information

NPI: 1558403048
Provider Name (Legal Business Name): JO ANN NIEVES ARNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE MIAMI CHILDREN'S HOSPITAL, CARDIOLOGY
MIAMI FL
33155-3009
US

IV. Provider business mailing address

11824 NW 9TH ST
CORAL SPRINGS FL
33071-5042
US

V. Phone/Fax

Practice location:
  • Phone: 786-624-4344
  • Fax: 305-662-8304
Mailing address:
  • Phone: 954-755-2253
  • Fax: 305-662-8304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberARNP1969132
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: