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General NPI Number Information
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NPI Number | 1962868810
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Entity Type | Organization
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Legal Business Name | ELITE NURSE PRACTITIONERS, LLC
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 6646 SW 63RD TER
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-2023
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Country | US
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Telephone | 305-726-7888
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Fax |
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Provider Business Mailing Address
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Address Line | 6646 SW 63RD TER
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-2023
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Country | US
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Telephone | 305-726-7888
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND RODRIGUEZ AMPUDIA
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Credential |
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Telephone | 305-726-7888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP9265567
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License Number State | FL
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