Provider Demographics
NPI:1235839648
Name:VIERNES-GAYTAN, EMMA (RN, BSN, CCRN-CSC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:VIERNES-GAYTAN
Suffix:
Gender:F
Credentials:RN, BSN, CCRN-CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19501 W COUNTRY CLUB DR APT 1908
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2479
Mailing Address - Country:US
Mailing Address - Phone:347-406-3147
Mailing Address - Fax:
Practice Address - Street 1:108 N 33RD CT
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6912
Practice Address - Country:US
Practice Address - Phone:305-899-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9466661163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9466661OtherFLORIDA BOARD OF NURSING