Provider Demographics
NPI:1558729970
Name:GUERRA OTERO, MIRIAM ISABEL (ARNP)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ISABEL
Last Name:GUERRA OTERO
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 1:14750 NW 77TH CT STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1507
Mailing Address - Country:US
Mailing Address - Phone:786-485-1005
Mailing Address - Fax:
Practice Address - Street 1:5901 SW 74TH ST STE 205
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5150
Practice Address - Country:US
Practice Address - Phone:305-666-8691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9387139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily