Healthcare Provider Details

I. General information

NPI: 1831720218
Provider Name (Legal Business Name): FARAH MARIA HORTA BONNIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 SUNSET DR STE 212
SOUTH MIAMI FL
33143-4529
US

IV. Provider business mailing address

14680 SW 8TH ST STE 205
MIAMI FL
33184-3138
US

V. Phone/Fax

Practice location:
  • Phone: 305-663-0710
  • Fax: 305-665-3051
Mailing address:
  • Phone: 305-549-8937
  • Fax: 786-801-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11005242
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: