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General NPI Number Information
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NPI Number | 1346099348
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Entity Type | Individual
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Provider Name | LOURDES BEATRIZ MASEDA APRN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2024
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 2111 SOLE MIA WAY
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2492
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Country | US
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Telephone | 305-243-1815
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Fax | 305-243-4613
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Provider Business Mailing Address
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Address Line | 2111 SOLE MIA WAY
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2492
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Country | US
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Telephone | 305-243-1815
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Fax | 305-243-4613
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 11031461
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License Number State | FL
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