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General NPI Number Information
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NPI Number | 1396566790
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Entity Type | Individual
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Provider Name | ANNA MUDRYTSKA
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Gender | Female
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 8375 NW 53RD ST STE 240
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City | MIAMI
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State | FL
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Zip | 33166-4611
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Country | US
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Telephone | 305-898-8375
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Fax | 305-689-8632
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Provider Business Mailing Address
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Address Line | 2500 INAGUA AVE
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City | MIAMI
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State | FL
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Zip | 33133-3812
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Country | US
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Telephone | 305-850-9935
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11035991
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License Number State | FL
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