Provider Demographics
NPI:1346834017
Name:MERIDA FUENTES, ISABEL Y (APRN)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:Y
Last Name:MERIDA FUENTES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PONCE DE LEON BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4475
Mailing Address - Country:US
Mailing Address - Phone:786-808-8555
Mailing Address - Fax:305-982-8798
Practice Address - Street 1:2020 PONCE DE LEON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4475
Practice Address - Country:US
Practice Address - Phone:786-808-8555
Practice Address - Fax:305-982-8798
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily