Healthcare Provider Details

I. General information

NPI: 1467879361
Provider Name (Legal Business Name): YAREMI ALLEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE SUITE #107
MIAMI FL
33133-4236
US

IV. Provider business mailing address

9440 SW 106TH CT
MIAMI FL
33176-2653
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-0302
  • Fax: 305-854-0308
Mailing address:
  • Phone: 305-458-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9274085
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: