Provider Demographics
NPI:1538644620
Name:CAPELLA, BIANCA M (APRN)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:M
Last Name:CAPELLA
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 1:11104 SW 154TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4528
Mailing Address - Country:US
Mailing Address - Phone:786-502-6595
Mailing Address - Fax:
Practice Address - Street 1:11104 SW 154TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4528
Practice Address - Country:US
Practice Address - Phone:786-502-6595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9279077363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care