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General NPI Number Information
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NPI Number | 1275003790
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Entity Type | Individual
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Provider Name | LORETA ANON NP
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Gender | Female
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Dates
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Enumeration Date | 11/27/2018
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-8508
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 NW 151ST ST STE 200B
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2437
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Country | US
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Telephone | 954-639-7119
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Fax | 954-639-7124
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-334407
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11000305
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11000305
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License Number State | FL
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