Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN11017213 | FL |
NPI | 1003567751 |
---|---|
Provider Name | Arlen Vega |
First Address | Miami, FL 33125-5288 |
Second Address | Miami, FL 33136-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2022 |
Last Update Date | 14/01/2022 |