Healthcare Provider Details

I. General information

NPI: 1679596001
Provider Name (Legal Business Name): MARTHA CECILIA JARAMILLO N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 NW 14TH ST STE 212
MIAMI FL
33125-1609
US

IV. Provider business mailing address

1350 NW 14TH ST STE 212
MIAMI FL
33125-1609
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-5045
  • Fax:
Mailing address:
  • Phone: 305-575-5045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP130879
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP130879
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP9461221
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: