Provider Demographics
NPI:1316580202
Name:QUISPE, MICHELLE ELIZABETH (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:QUISPE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:ELIZABETH
Other - Last Name:QUISPE-RUIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, APRN, FNP-BC
Mailing Address - Street 1:14208 SW 117TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8635
Mailing Address - Country:US
Mailing Address - Phone:786-512-8247
Mailing Address - Fax:
Practice Address - Street 1:7800 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2631
Practice Address - Country:US
Practice Address - Phone:305-702-2132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily