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General NPI Number Information
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NPI Number | 1740784016
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Entity Type | Individual
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Provider Name | JESSICA EDITH MOURINO
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Gender | Female
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1951 SW 172ND AVE STE 314
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City | MIRAMAR
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State | FL
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Zip | 33029-5614
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Country | US
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Telephone | 954-447-5206
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 MAIN ST APT 1641
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2297
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Country | US
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Telephone | 305-726-4911
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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 | APRN002859
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9364011
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License Number State | FL
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