Provider Demographics
NPI:1104126176
Name:SALLENT, LUISA MARIA (ARNP)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:MARIA
Last Name:SALLENT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14619 GLENCAIRN RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1447
Mailing Address - Country:US
Mailing Address - Phone:305-401-8209
Mailing Address - Fax:486-269-2300
Practice Address - Street 1:14619 GLENCAIRN RD
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1447
Practice Address - Country:US
Practice Address - Phone:305-401-8209
Practice Address - Fax:486-269-2300
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9210044363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health