Provider Demographics
NPI:1508373556
Name:TRETO, GRISEL VALLADARES (ARNP)
Entity Type:Individual
Prefix:
First Name:GRISEL
Middle Name:VALLADARES
Last Name:TRETO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 SW 5TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3645
Mailing Address - Country:US
Mailing Address - Phone:786-547-2485
Mailing Address - Fax:
Practice Address - Street 1:6820 SW 5TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3645
Practice Address - Country:US
Practice Address - Phone:786-547-2485
Practice Address - Fax:786-547-2485
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9271615363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health