Provider Demographics
NPI:1225517907
Name:NADUPARAMBIL, JESSY S
Entity Type:Individual
Prefix:
First Name:JESSY
Middle Name:S
Last Name:NADUPARAMBIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1119
Mailing Address - Country:US
Mailing Address - Phone:305-326-6544
Mailing Address - Fax:305-326-6574
Practice Address - Street 1:900 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1119
Practice Address - Country:US
Practice Address - Phone:305-326-6544
Practice Address - Fax:305-326-6574
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9188958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty