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General NPI Number Information
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NPI Number | 1891382974
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Entity Type | Individual
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Provider Name | IVEN DUPERA APRN
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Gender | Male
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 7000 NW 41ST ST
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City | MIAMI
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State | FL
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Zip | 33166-6817
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Country | US
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Telephone | 786-263-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 1175 NW 155TH LN APT 207
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City | MIAMI
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State | FL
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Zip | 33169-6327
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Country | US
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Telephone |
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 9420416
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11012611
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License Number State | FL
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