MEDICARE: MR. EVELIO VARANY ESTRADA MOLINA APRN, CBHCM-S

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	171M00000X	Case Manager/Care Coordinator	CBHCMS100904	FL
2	363LF0000X	Family Nurse Practitioner	APRN11007522	FL
3	363LP2300X	Primary Care Nurse Practitioner	APRN11007522	FL
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11007522	FL

General Provider Information

NPI Number	:	1912547019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EVELIO VARANY ESTRADA MOLINA APRN, CBHCM-S

Provider Business Mailing Address
First Line	:	11117 W OKEECHOBEE RD STE 104
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4200
Country	:	US
Telephone Number	:	786-438-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	11117 W OKEECHOBEE RD STE 104
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4200
Country	:	US
Telephone Number	:	786-438-9145
Fax Number	:	786-408-5853

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

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	04/05/2024

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