Provider Demographics
NPI:1750192944
Name:CORPAS FUSTER, SANDRA (MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:CORPAS FUSTER
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 NW 59TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4749
Mailing Address - Country:US
Mailing Address - Phone:786-439-6742
Mailing Address - Fax:
Practice Address - Street 1:225 NW 59TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4749
Practice Address - Country:US
Practice Address - Phone:786-439-6742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF12240052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily