1285874792 NPI number — SYLMA MARIA MILLARES A.R.N.P.

Table of content: SYLMA MARIA MILLARES A.R.N.P. (NPI 1285874792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285874792 NPI number — SYLMA MARIA MILLARES A.R.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLARES
Provider First Name:
SYLMA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
A.R.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285874792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12204 SW 95TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33186-1927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-271-8509
Provider Business Mailing Address Fax Number:
786-558-8917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10250 SW 56TH ST STE C101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33165-7065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-271-8509
Provider Business Practice Location Address Fax Number:
786-558-8917
Provider Enumeration Date:
02/23/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  ARNP 3277452 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003966500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".