Provider Demographics
NPI:1295522654
Name:DIAZ GRANADOS ARANGO, LAURA (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DIAZ GRANADOS ARANGO
Suffix:
Gender:
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21420 SW 94TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3736
Mailing Address - Country:US
Mailing Address - Phone:305-305-8217
Mailing Address - Fax:
Practice Address - Street 1:900 SW 8TH ST # CU-2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3751
Practice Address - Country:US
Practice Address - Phone:786-312-0759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038695363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health