Provider Demographics
NPI:1306635412
Name:VAZQUEZ NADAL, JEANNETTE (FNP)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:
Last Name:VAZQUEZ NADAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3184 SW 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3953
Mailing Address - Country:US
Mailing Address - Phone:786-368-1954
Mailing Address - Fax:
Practice Address - Street 1:3184 SW 142ND AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3953
Practice Address - Country:US
Practice Address - Phone:786-368-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily