Healthcare Provider Details

I. General information

NPI: 1013293927
Provider Name (Legal Business Name): JENNY IVETTE MORALES-SOTOMAYOR CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 95TH ST
MIAMI FL
33150-2038
US

IV. Provider business mailing address

PO BOX 741847
ATLANTA GA
30374-1847
US

V. Phone/Fax

Practice location:
  • Phone: 787-662-5032
  • Fax: 866-665-2702
Mailing address:
  • Phone:
  • Fax: 866-665-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9329952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: