Provider Demographics
NPI:1710084629
Name:BRUNO, RACHELLE (ARNP, WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:
Last Name:BRUNO
Suffix:
Gender:F
Credentials:ARNP, WHNP-BC
Other - Prefix:MS
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:BRUNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP, WHNP-BC
Mailing Address - Street 1:100 NW 170TH ST STE 304
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5511
Mailing Address - Country:US
Mailing Address - Phone:305-653-4105
Mailing Address - Fax:305-652-3566
Practice Address - Street 1:100 NW 170TH ST STE 304
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5511
Practice Address - Country:US
Practice Address - Phone:305-653-4105
Practice Address - Fax:305-652-3566
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1882792363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301446100Medicaid
FLY5643XMedicare ID - Type Unspecified