Provider Demographics
NPI:1174005250
Name:RAVE, JULIETH ANDREA (RNP)
Entity Type:Individual
Prefix:
First Name:JULIETH
Middle Name:ANDREA
Last Name:RAVE
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:JULIETH
Other - Middle Name:ANDREA
Other - Last Name:RAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNP
Mailing Address - Street 1:3663 S MIAMI AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4253
Mailing Address - Country:US
Mailing Address - Phone:305-285-4400
Mailing Address - Fax:
Practice Address - Street 1:3663 S MIAMI AVE STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:304-285-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9309205363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health