Provider Demographics
NPI:1063107423
Name:NURSE PRACTITIONERS OF MIAMI LLC
Entity type:Organization
Organization Name:NURSE PRACTITIONERS OF MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAYELIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:CANIZARES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:305-979-1892
Mailing Address - Street 1:5852 SW 33RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4904
Mailing Address - Country:US
Mailing Address - Phone:305-979-1892
Mailing Address - Fax:
Practice Address - Street 1:5852 SW 33RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4904
Practice Address - Country:US
Practice Address - Phone:305-979-1892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty