Provider Demographics
NPI:1750868857
Name:IBANEZ, NATALIA (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:IBANEZ
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HCA FLORIDA AVENTURA HOSPITAL
Mailing Address - Street 2:20900 BISCAYNE BOULEVARD
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180
Mailing Address - Country:US
Mailing Address - Phone:305-343-8254
Mailing Address - Fax:
Practice Address - Street 1:HCA FLORIDA AVENTURA HOSPITAL
Practice Address - Street 2:20900 BISCAYNE BLVD
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1407
Practice Address - Country:US
Practice Address - Phone:305-343-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022299363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty