Healthcare Provider Details

I. General information

NPI: 1306798020
Provider Name (Legal Business Name): KATERINE TAMAYO ALCANTARA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 JANN AVE
OPA LOCKA FL
33054-3324
US

IV. Provider business mailing address

900 JANN AVE
OPA LOCKA FL
33054-3324
US

V. Phone/Fax

Practice location:
  • Phone: 786-722-1342
  • Fax:
Mailing address:
  • Phone: 786-722-1342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11044710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: