Provider Demographics
NPI:1245839950
Name:CARDENAS RAMON, ITSEL (ARNP)
Entity type:Individual
Prefix:
First Name:ITSEL
Middle Name:
Last Name:CARDENAS RAMON
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 1:7000 SW 97TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1492
Mailing Address - Country:US
Mailing Address - Phone:305-392-1264
Mailing Address - Fax:305-646-1756
Practice Address - Street 1:7000 SW 97TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1492
Practice Address - Country:US
Practice Address - Phone:305-392-1264
Practice Address - Fax:305-646-1756
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily