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General NPI Number Information
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NPI Number | 1487366852
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Entity Type | Individual
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Provider Name | RAQUEL ROSARIO FANELLA APRN
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Gender | Female
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 351 N LEJEUNE RD STE 308
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City | MIAMI
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State | FL
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Zip | 33126-5688
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Country | US
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Telephone | 305-994-1825
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Fax |
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Provider Business Mailing Address
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Address Line | 11030 N KENDALL DR STE 100
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City | MIAMI
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State | FL
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Zip | 33176-8814
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Country | US
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Telephone | 305-994-1825
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11022987
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | APRN11022987
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License Number State | FL
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