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General NPI Number Information
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NPI Number | 1104701366
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Entity Type | Individual
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Provider Name | MICKEY MIQUELI-PIAZZA ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 13535 SW 72ND AVE STE 170
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City | PORTLAND
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State | OR
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Zip | 97223-8074
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Country | US
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Telephone | 971-300-0654
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Fax |
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Provider Business Mailing Address
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Address Line | 455 DEER CREEK LAKE POINT SOUTH LN
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-8462
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Country | US
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Telephone | 561-906-9066
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11040949
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11040949
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10050055
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License Number State | OR
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