Provider Demographics
NPI:1275230138
Name:PRADO DEL REY, ERICA MONIQUE (MSN, APRN, NNC-BC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MONIQUE
Last Name:PRADO DEL REY
Suffix:
Gender:F
Credentials:MSN, APRN, NNC-BC
Other - Prefix:MRS
Other - First Name:ERICA
Other - Middle Name:MONIQUE
Other - Last Name:DEL REY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11342 NW 65TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3626
Mailing Address - Country:US
Mailing Address - Phone:786-566-7914
Mailing Address - Fax:
Practice Address - Street 1:1005 JOE DIMAGGIO DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5402
Practice Address - Country:US
Practice Address - Phone:954-265-5324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9515442163WN0002X
FL11024964363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9515442OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH
FLAPRN11024964OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH