Provider Demographics
NPI:1003308685
Name:JIRON, JOSE R (ARNP)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:JIRON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11760 SW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2513
Mailing Address - Country:US
Mailing Address - Phone:305-979-1151
Mailing Address - Fax:
Practice Address - Street 1:1321 NW 14TH ST STE 510
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1659
Practice Address - Country:US
Practice Address - Phone:305-243-5554
Practice Address - Fax:305-243-1731
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9335476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9335476OtherSTATE OF FLORIDA