1760058051 NPI number — MIRIELA RIEUMONT APRN

Table of content: MIRIELA RIEUMONT APRN (NPI 1760058051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760058051 NPI number — MIRIELA RIEUMONT APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIEUMONT
Provider First Name:
MIRIELA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1760058051
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6100 BLUE LAGOON DR STE 365
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:
33126-7010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-322-7333
Provider Business Mailing Address Fax Number:
786-347-5022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14285 SW 42ND ST STE 205
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:
33175-6416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-845-5600
Provider Business Practice Location Address Fax Number:
786-363-8157
Provider Enumeration Date:
05/27/2021

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: 363LF0000X , with the licence number:  11013362 , 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: 114730000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com