Healthcare Provider Details

I. General information

NPI: 1851180137
Provider Name (Legal Business Name): APRN HEALTH CONSULT CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10122 SW 139TH ST
MIAMI FL
33176-6682
US

IV. Provider business mailing address

10122 SW 139TH ST
MIAMI FL
33176-6682
US

V. Phone/Fax

Practice location:
  • Phone: 786-201-6249
  • Fax: 925-281-3249
Mailing address:
  • Phone: 786-201-6249
  • Fax: 925-281-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. OLUWOLE PITAN
Title or Position: CEO
Credential: APRN
Phone: 786-201-6249