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General NPI Number Information
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NPI Number | 1851013304
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Entity Type | Individual
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Provider Name | KRYSTELL FERNANDEZ-GREGORICH ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 836 PONCE DE LEON BLVD STE 200
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City | CORAL GABLES
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State | FL
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Zip | 33134-3068
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Country | US
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Telephone | 305-441-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 680 NE 64TH ST APT A408
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City | MIAMI
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State | FL
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Zip | 33138-6293
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Country | US
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Telephone | 786-343-8335
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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 | APRN11021277
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License Number State | FL
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