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General NPI Number Information
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NPI Number | 1114169141
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Entity Type | Organization
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Legal Business Name | NURSE PRACTITIONER ASSOCIATES OF SOUTH FLORIDA, P.A.
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 04/06/2009
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Provider Practice Location Address
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Address Line | 9737 NW 41ST ST STE 418
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City | DORAL
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State | FL
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Zip | 33178-2924
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Country | US
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Telephone | 305-490-0494
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Fax |
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Provider Business Mailing Address
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Address Line | 9737 NW 41ST ST STE 418
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City | DORAL
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State | FL
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Zip | 33178-2924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HENRY HENAO
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Credential | MSN, ARNP, FNP-BC
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Telephone | 305-490-0494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9219002
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License Number State | FL
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