Provider Demographics
NPI:1730134347
Name:MENESES, NOHEMI T (CRNA)
Entity Type:Individual
Prefix:
First Name:NOHEMI
Middle Name:T
Last Name:MENESES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13425 SW 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-6075
Mailing Address - Country:US
Mailing Address - Phone:305-233-4098
Mailing Address - Fax:
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-285-2771
Practice Address - Fax:305-285-5064
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP789712367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1006OtherBCBS
FL033353100Medicaid
FLG1006ZMedicare ID - Type Unspecified