Healthcare Provider Details

I. General information

NPI: 1467628834
Provider Name (Legal Business Name): MYRA LUZ ABRIAM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-0293
US

IV. Provider business mailing address

50 STURTEVANT ST
ORLANDO FL
32806-2022
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-0921
  • Fax:
Mailing address:
  • Phone: 407-649-6907
  • Fax: 407-481-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4061021
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9299791
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number26NJ00113700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: