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General NPI Number Information
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NPI Number | 1386536696
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Entity Type | Individual
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Provider Name | GENESIS M MORA SANTANA NP
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 10981 MARKS WAY
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City | MIRAMAR
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State | FL
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Zip | 33025-1703
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Country | US
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Telephone | 954-486-4085
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1534
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City | HALLANDALE BEACH
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State | FL
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Zip | 33008-1534
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Country | US
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Telephone |
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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 | APRN11040814
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License Number State | FL
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