Provider Demographics
NPI:1922689934
Name:SAURRALES, NURIA (APRN)
Entity Type:Individual
Prefix:
First Name:NURIA
Middle Name:
Last Name:SAURRALES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20023 NW 64TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2136
Mailing Address - Country:US
Mailing Address - Phone:786-488-4271
Mailing Address - Fax:
Practice Address - Street 1:5636 SW 164TH TER
Practice Address - Street 2:
Practice Address - City:SW RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33331-1343
Practice Address - Country:US
Practice Address - Phone:786-488-4271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012497363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner