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General NPI Number Information
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NPI Number | 1508448986
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Entity Type | Individual
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Provider Name | JAMIELA MONIQUE KERSELLIUS
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Gender | Female
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Dates
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Enumeration Date | 04/25/2021
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Last Update Date | 04/25/2021
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Provider Practice Location Address
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Address Line | 1190 NW 95TH ST STE 203
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City | MIAMI
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State | FL
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Zip | 33150-2064
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Country | US
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Telephone | 561-287-6009
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 814583
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City | HOLLYWOOD
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State | FL
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Zip | 33081-4583
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Country | US
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Telephone | 561-287-6009
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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 | APRN11010800
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License Number State | FL
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