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General NPI Number Information
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NPI Number | 1528390663
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL NURSE PRACTITIONER INC
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Dates
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Enumeration Date | 01/30/2010
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Last Update Date | 01/30/2010
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Provider Practice Location Address
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Address Line | 29157 SW 186TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-2439
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Country | US
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Telephone | 305-905-6994
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Fax | 305-245-9994
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Provider Business Mailing Address
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Address Line | 29157 SW 186TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-2439
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Country | US
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Telephone | 305-905-6994
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Fax | 305-245-9994
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARGARITA HERNANDEZ
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Credential | ARNP
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Telephone | 305-905-6994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP2678862
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License Number State | FL
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