Provider Demographics
NPI:1477227973
Name:FUENTES, ONIX ZHENIA (APRN)
Entity Type:Individual
Prefix:
First Name:ONIX
Middle Name:ZHENIA
Last Name: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 1:5900 NE 2ND TER
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1826
Mailing Address - Country:US
Mailing Address - Phone:954-804-6471
Mailing Address - Fax:
Practice Address - Street 1:100 NW 170TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169
Practice Address - Country:US
Practice Address - Phone:305-654-6850
Practice Address - Fax:305-654-6858
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2022-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF07210513363L00000X
FLAPRN11014617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner