Provider Demographics
NPI:1679640965
Name:AMADOR, VANESSA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:AMADOR
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 1:13016 SW 136TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8437
Mailing Address - Country:US
Mailing Address - Phone:305-962-8937
Mailing Address - Fax:
Practice Address - Street 1:9200 SW 72ND ST
Practice Address - Street 2:BLDG 4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3240
Practice Address - Country:US
Practice Address - Phone:305-412-8315
Practice Address - Fax:305-412-8936
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9165887363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health