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General NPI Number Information
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NPI Number | 1629584594
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Entity Type | Individual
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Provider Name | KRYSTEN MARIE SARGENTON ARNP BC
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Gender | Female
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 1475 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1002
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Country | US
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Telephone | 786-282-0306
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Fax |
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Provider Business Mailing Address
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Address Line | 1861 SW 4TH AVE
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City | MIAMI
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State | FL
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Zip | 33129-1029
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Country | US
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Telephone | 786-282-0306
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9386059
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License Number State | FL
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