Provider Demographics
NPI:1811551880
Name:HERRERA ESTUPINAN, SOLEDAD (ARNP)
Entity Type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:HERRERA ESTUPINAN
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 1:5200 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-2706
Mailing Address - Country:US
Mailing Address - Phone:305-751-8626
Mailing Address - Fax:
Practice Address - Street 1:60 E 3RD ST STE 202
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4973
Practice Address - Country:US
Practice Address - Phone:786-347-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily