Healthcare Provider Details

I. General information

NPI: 1952024051
Provider Name (Legal Business Name): RAQUEL ADRIANA BARON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

2334 S CYPRESS BEND DR APT 203
POMPANO BEACH FL
33069-4499
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5437
  • Fax:
Mailing address:
  • Phone: 561-305-3529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number11021536
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: