Provider Demographics
NPI:1124560743
Name:MESIDOR, NATALIE GABRIEL (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:GABRIEL
Last Name:MESIDOR
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:16495 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4465
Mailing Address - Country:US
Mailing Address - Phone:954-404-9297
Mailing Address - Fax:954-404-9297
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1096
Practice Address - Country:US
Practice Address - Phone:305-585-8456
Practice Address - Fax:954-404-9297
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2018-12-10
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Provider Licenses
StateLicense IDTaxonomies
FL9190673363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health