MEDICARE: DACHEL CARRENO 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	363LF0000X	Family Nurse Practitioner	APRN11002012	FL
2	163W00000X	Registered Nurse	RN9365413	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

General Provider Information

NPI Number	:	1306403985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DACHEL CARRENO APRN

Provider Business Mailing Address
First Line	:	3875 NW 168TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-4515
Country	:	US
Telephone Number	:	786-218-7122
Fax Number	:

Provider Business Practice Location Address
First Line	:	3875 NW 168TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-4515
Country	:	US
Telephone Number	:	786-218-7122
Fax Number	:

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

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	06/22/2026

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Directions to “ DACHEL CARRENO APRN” Practice Location

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