Provider Demographics
NPI:1427586551
Name:POVIONES GARBALOSA ARNP INC
Entity type:Organization
Organization Name:POVIONES GARBALOSA ARNP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:POVIONES GARBALOSA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-394-0811
Mailing Address - Street 1:20230 NW 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1335
Mailing Address - Country:US
Mailing Address - Phone:786-394-0811
Mailing Address - Fax:
Practice Address - Street 1:11760 BIRD RD STE 539
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8100
Practice Address - Country:US
Practice Address - Phone:305-228-6200
Practice Address - Fax:305-228-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9309698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty