Healthcare Provider Details

I. General information

NPI: 1194120642
Provider Name (Legal Business Name): MYRLENE MIOT-DESMORNES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8358 W OAKLAND PARK BLVD STE 103
SUNRISE FL
33351-7340
US

IV. Provider business mailing address

8358 W OAKLAND PARK BLVD STE 103
SUNRISE FL
33351-7340
US

V. Phone/Fax

Practice location:
  • Phone: 954-395-8440
  • Fax: 305-290-8603
Mailing address:
  • Phone: 954-395-8440
  • Fax: 305-290-8603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9225787
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: