Healthcare Provider Details

I. General information

NPI: 1467809996
Provider Name (Legal Business Name): IRMA CHRISTIAN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NW 170TH ST
NORTH MIAMI BEACH FL
33169-5521
US

IV. Provider business mailing address

74 EAST DR
NORTH MIAMI BEACH FL
33162-1709
US

V. Phone/Fax

Practice location:
  • Phone: 305-654-5200
  • Fax:
Mailing address:
  • Phone: 305-710-3374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberARNP 3357082
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: