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General NPI Number Information
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NPI Number | 1245789882
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Entity Type | Individual
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Provider Name | DIANELIS HERRERA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 6075 SUNSET DR 4TH FLOOR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5000
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Country | US
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Telephone | 305-669-1808
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Fax |
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Provider Business Mailing Address
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Address Line | 191 NW 122ND CT
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City | MIAMI
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State | FL
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Zip | 33182-2053
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Country | US
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Telephone | 786-394-7189
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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 | 9312357
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License Number State | FL
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