Provider Demographics
NPI:1972139087
Name:SUBERVI, PRISCILLA A (RN)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:A
Last Name:SUBERVI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:
Other - Last Name:ARMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10900 SW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3522
Mailing Address - Country:US
Mailing Address - Phone:305-213-1650
Mailing Address - Fax:
Practice Address - Street 1:363 ARAGON AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5071
Practice Address - Country:US
Practice Address - Phone:786-812-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9279892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse