Provider Demographics
NPI:1013385053
Name:FABRE, MISELINE (FNP)
Entity Type:Individual
Prefix:MS
First Name:MISELINE
Middle Name:
Last Name:FABRE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MISELINE
Other - Middle Name:
Other - Last Name:FABRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:930 NE 157TH TER
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-5304
Mailing Address - Country:US
Mailing Address - Phone:305-318-1388
Mailing Address - Fax:
Practice Address - Street 1:930 NE 157TH TER
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-5304
Practice Address - Country:US
Practice Address - Phone:305-318-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9245364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily