Provider Demographics
NPI:1114496577
Name:MIRABELLI, TAMEIKA (NP)
Entity Type:Individual
Prefix:
First Name:TAMEIKA
Middle Name:
Last Name:MIRABELLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1950 NE 6TH ST UNIT 1593
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6541
Mailing Address - Country:US
Mailing Address - Phone:786-708-2404
Mailing Address - Fax:
Practice Address - Street 1:801 S UNIVERSITY DR STE C136
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3366
Practice Address - Country:US
Practice Address - Phone:954-693-9190
Practice Address - Fax:954-693-9184
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9349043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily