Provider Demographics
NPI:1376421594
Name:NOGUERA, TERESITA
Entity type:Individual
Prefix:
First Name:TERESITA
Middle Name:
Last Name:NOGUERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 WHITEHALL DR APT 105
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6607
Mailing Address - Country:US
Mailing Address - Phone:954-254-4255
Mailing Address - Fax:
Practice Address - Street 1:1504 WHITEHALL DR APT 105
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-6607
Practice Address - Country:US
Practice Address - Phone:954-254-4255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9555339163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine