MEDICARE: NAYVIS MIRANDA AGUERO APRN

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	363LP2300X	Primary Care Nurse Practitioner	APRN11023968	FL

General Provider Information

NPI Number	:	1205363868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAYVIS MIRANDA AGUERO APRN

Provider Business Mailing Address
First Line	:	7867 W 36TH AVE UNIT 104
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7530
Country	:	US
Telephone Number	:	786-704-2068
Fax Number	:

Provider Business Practice Location Address
First Line	:	10550 NW 77TH CT STE 308
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016-2072
Country	:	US
Telephone Number	:	305-863-2233
Fax Number	:	305-504-8813

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

Provider Enumeration Date	:	05/15/2017
Last Update Date	:	01/23/2024

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