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General NPI Number Information
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NPI Number | 1598648743
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Entity Type | Individual
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Provider Name | RENATA VALENTINA BOSCAN RAVELO
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 2245 SW 18TH AVE
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City | MIAMI
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State | FL
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Zip | 33145-3847
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Country | US
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Telephone | 305-606-9364
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Fax |
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Provider Business Mailing Address
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Address Line | 2245 SW 18TH AVE
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City | MIAMI
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State | FL
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Zip | 33145-3847
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Country | US
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Telephone | 305-606-9364
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-19360
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License Number State | FL
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