Healthcare Provider Details

I. General information

NPI: 1104607720
Provider Name (Legal Business Name): CLAUDIA MARIA AMENGUAL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAUDIA MARIA FITZPATRICK

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 SW 152ND ST
PALMETTO BAY FL
33157-1778
US

IV. Provider business mailing address

10923 SW 134TH CT
MIAMI FL
33186-3320
US

V. Phone/Fax

Practice location:
  • Phone: 305-251-2500
  • Fax:
Mailing address:
  • Phone: 305-824-7659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11009872
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2023007532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: