Healthcare Provider Details

I. General information

NPI: 1215344213
Provider Name (Legal Business Name): AMIRA EL KHOLY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 NE 125TH ST STE 206
NORTH MIAMI FL
33161-5833
US

IV. Provider business mailing address

731 SAND CREEK CIR
WESTON FL
33327-1205
US

V. Phone/Fax

Practice location:
  • Phone: 305-891-0050
  • Fax: 305-891-0497
Mailing address:
  • Phone: 305-310-3822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9310148
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9310148
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9310148
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9310148
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: