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General NPI Number Information
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NPI Number | 1285813972
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Entity Type | Individual
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Provider Name | NANETTE S GARAVITO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 05/02/2014
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Provider Practice Location Address
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Address Line | 9275 SW 152ND ST 101
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1701
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Country | US
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Telephone | 305-253-8869
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Fax | 305-233-9726
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Provider Business Mailing Address
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Address Line | 9767 SW 106TH TER
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City | MIAMI
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State | FL
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Zip | 33176-2848
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Country | US
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Telephone | 305-412-6312
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Fax | 305-412-6312
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9104391
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License Number State | FL
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