Healthcare Provider Details

I. General information

NPI: 1033613740
Provider Name (Legal Business Name): SIURKY A CIFUENTES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26085 S DIXIE HWY
NARANJA FL
33032-6613
US

IV. Provider business mailing address

14437 SW 12TH LN
MIAMI FL
33184-3250
US

V. Phone/Fax

Practice location:
  • Phone: 305-685-5688
  • Fax: 305-258-4264
Mailing address:
  • Phone: 786-449-4312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9284330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: