=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346903093
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAGALY Z SAUCO ABREU N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2021
-----------------------------------------------------
Last Update Date | 10/25/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10550 NW 77 CT SUITE 305
-----------------------------------------------------
City | HIALEAH GARDENS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-826-3072
-----------------------------------------------------
Fax | 305-826-3046
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10550 NW 77 CT SUITE 305
-----------------------------------------------------
City | HIALEAH GARDENS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-826-3072
-----------------------------------------------------
Fax | 305-826-3046
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN11015785
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | APRN11015785
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------