Provider Demographics
NPI:1336565654
Name:PRENTISS, VALERIE ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:PRENTISS
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 1:3200 SW 60TH CT
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4000
Mailing Address - Country:US
Mailing Address - Phone:305-662-8330
Mailing Address - Fax:305-663-2813
Practice Address - Street 1:3200 SW 60TH CT
Practice Address - Street 2:SUITE 302
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-662-8330
Practice Address - Fax:305-663-2813
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9280873363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics