Provider Demographics
NPI:1629569298
Name:CAPDEVILA, GINEL (MSN, ARNP, PPCNP-BC)
Entity Type:Individual
Prefix:
First Name:GINEL
Middle Name:
Last Name:CAPDEVILA
Suffix:
Gender:F
Credentials:MSN, ARNP, PPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9742 SW 132ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2239
Mailing Address - Country:US
Mailing Address - Phone:786-546-2483
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 62ND AVE STE 3109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-662-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-19
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9295048363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty