Healthcare Provider Details

I. General information

NPI: 1578227328
Provider Name (Legal Business Name): MRS. STEPHANIE AGUIRRE-BARCENAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 05/02/2024
Certification Date: 04/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 W BROWARD BLVD
PLANTATION FL
33324-2701
US

IV. Provider business mailing address

13263 SW 112TH TER
MIAMI FL
33186-7930
US

V. Phone/Fax

Practice location:
  • Phone: 954-473-6600
  • Fax:
Mailing address:
  • Phone: 786-337-0451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11016255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: