Provider Demographics
NPI:1982012449
Name:JARAMILLO, JANICE (C-PNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:C-PNP
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:C-PNP
Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-3440
Mailing Address - Fax:
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-3440
Practice Address - Fax:305-243-2918
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382451-1363LP0200X
FL9453730363LP0200X
FLARNP9453730363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics