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General NPI Number Information
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NPI Number | 1669198545
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Entity Type | Individual
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Provider Name | JUSMAR FLEITES
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Gender | Male
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 101 SW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-1428
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Country | US
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Telephone | 305-642-5366
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Fax |
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Provider Business Mailing Address
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Address Line | 520 E 28TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3644
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Country | US
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Telephone | 786-775-9314
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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 | APRN11022461
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License Number State | FL
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