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General NPI Number Information
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NPI Number | 1750762654
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Entity Type | Individual
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Provider Name | NARIEL PENA PACHECO
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Gender | Male
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 11009 SW 186TH ST
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City | CUTLER BAY
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State | FL
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Zip | 33157-6810
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Country | US
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Telephone | 786-608-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 10502 SW 144TH CT
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City | MIAMI
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State | FL
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Zip | 33186-2922
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Country | US
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Telephone | 786-608-0710
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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 | 11002188
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 022376300
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License Number State | FL
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