Provider Demographics
NPI:1336422047
Name:CARRION, BERTHA (ARNP)
Entity type:Individual
Prefix:
First Name:BERTHA
Middle Name:
Last Name:CARRION
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 1:13261 SW 209TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-7502
Mailing Address - Country:US
Mailing Address - Phone:786-278-1940
Mailing Address - Fax:305-351-8788
Practice Address - Street 1:13261 SW 209TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-7502
Practice Address - Country:US
Practice Address - Phone:786-278-1940
Practice Address - Fax:305-351-8788
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9265855363LF0000X
FLARNP9265855363LF0000X, 363LA2200X, 363LG0600X, 363LP0200X, 363LP2300X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health