Provider Demographics
NPI:1215659545
Name:SOMARRIBA, CHELSEY ELAINE SUNICO (APRN)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:ELAINE SUNICO
Last Name:SOMARRIBA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16036 SW 87TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5297
Mailing Address - Country:US
Mailing Address - Phone:305-213-7576
Mailing Address - Fax:
Practice Address - Street 1:2650 NW 2ND ST # 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-6234
Practice Address - Country:US
Practice Address - Phone:352-237-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005804363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics