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General NPI Number Information
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NPI Number | 1346803350
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Entity Type | Individual
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Provider Name | DORIS TERAN
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Gender | Female
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 650 SE 9TH CT APT 103
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City | HIALEAH
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State | FL
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Zip | 33010-5767
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Country | US
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Telephone | 305-244-1586
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Fax |
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Provider Business Mailing Address
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Address Line | 650 SE 9TH CT APT 103
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City | HIALEAH
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State | FL
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Zip | 33010-5767
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Country | US
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Telephone | 305-244-1586
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11000251
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License Number State | FL
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