MEDICARE: ADRIAN MOREDO 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	363LC0200X	Critical Care Medicine Nurse Practitioner	APRN11047990	FL

General Provider Information

NPI Number	:	1588596415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN MOREDO APRN

Provider Business Mailing Address
First Line	:	4012 SW 102ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4961
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4012 SW 102ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4961
Country	:	US
Telephone Number	:	786-832-2741
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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