Healthcare Provider Details

I. General information

NPI: 1972440667
Provider Name (Legal Business Name): OVIDIO ALAIN NARANJO AGACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15796 SW 26TH ST
MIRAMAR FL
33027-4271
US

IV. Provider business mailing address

15796 SW 26TH ST
MIRAMAR FL
33027-4271
US

V. Phone/Fax

Practice location:
  • Phone: 305-310-1220
  • Fax:
Mailing address:
  • Phone: 305-310-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11047193
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: