MEDICARE: SAIYONARA SURI 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	APRN11012580	FL

General Provider Information

NPI Number	:	1891468971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAIYONARA SURI APRN

Provider Business Mailing Address
First Line	:	1485 W 46TH ST APT 518A
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7834
Country	:	US
Telephone Number	:	305-725-4757
Fax Number	:

Provider Business Practice Location Address
First Line	:	1485 W 46TH ST
Second Line	:	APT 518 A
City	:	HIALEAH
State	:	FL
Zip	:	33012-7834
Country	:	US
Telephone Number	:	305-725-4757
Fax Number	:

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

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	07/26/2021

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Directions to “ SAIYONARA SURI APRN” Practice Location

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