Provider Demographics
NPI:1346695673
Name:MOJENA, MARIA LUISA (APRN FNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:MOJENA
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4104
Mailing Address - Country:US
Mailing Address - Phone:305-244-6996
Mailing Address - Fax:305-777-7121
Practice Address - Street 1:3380 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4104
Practice Address - Country:US
Practice Address - Phone:305-244-6996
Practice Address - Fax:305-777-7121
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-23
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9297802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112031100Medicaid