Provider Demographics
NPI:1275013898
Name:DIEZ SAMPEDRO, ANA (PHD, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:DIEZ SAMPEDRO
Suffix:
Gender:F
Credentials:PHD, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 SW 33RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2225
Mailing Address - Country:US
Mailing Address - Phone:203-927-6338
Mailing Address - Fax:
Practice Address - Street 1:1921 SW 33RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145
Practice Address - Country:US
Practice Address - Phone:203-927-6338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9355901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily