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General NPI Number Information
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NPI Number | 1093201659
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Entity Type | Individual
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Provider Name | JESSICA CARDENAS
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Gender | Female
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 7331 NW 173RD DR APT 100
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City | HIALEAH
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State | FL
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Zip | 33015-8417
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Country | US
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Telephone | 305-202-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 7331 NW 173RD DR APT 100
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City | HIALEAH
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State | FL
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Zip | 33015-8417
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Country | US
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Telephone | 305-202-2520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9402024
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9402024
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License Number State | FL
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