Provider Demographics
NPI:1154835585
Name:GATA FROMETA, ISMELIS (ARNP)
Entity Type:Individual
Prefix:
First Name:ISMELIS
Middle Name:
Last Name:GATA FROMETA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW 72ND AVE APT 1304
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7752
Mailing Address - Country:US
Mailing Address - Phone:305-794-4106
Mailing Address - Fax:
Practice Address - Street 1:18610 NW 87TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3518
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9428906363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology