MEDICARE: KATIA MIRANDA CALNICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11022187	FL
2	363LF0000X	Family Nurse Practitioner	F09220090	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	F09220090	OTHER	FL	ADVANCE REGISTERED NURSE PRACTITIONER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144941378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIA MIRANDA CALNICK

Provider Business Mailing Address
First Line	:	13292 SW 274TH TER
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-8589
Country	:	US
Telephone Number	:	786-547-3887
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 W 76TH ST STE 408-410
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5539
Country	:	US
Telephone Number	:	786-472-0523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2022
Last Update Date	:	02/18/2026

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Directions to “ KATIA MIRANDA CALNICK ” Practice Location

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