Healthcare Provider Details
I. General information
NPI: 1609000884
Provider Name (Legal Business Name): WENDY MARISELA CARDENAS ARNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/04/2009
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6200 SW 72ND ST STE 130
SOUTH MIAMI FL
33143-4832
US
IV. Provider business mailing address
8900 N KENDALL DR
MIAMI FL
33176-2118
US
V. Phone/Fax
- Phone: 305-271-6159
- Fax:
- Phone: 786-596-9758
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SA2100X |
| Taxonomy | Acute Care Clinical Nurse Specialist |
| License Number | ARNP 9174992 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN9174992 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: