Provider Demographics
NPI:1790588408
Name:MIRALLES, EVENIE FRANTZDIA (APRN)
Entity type:Individual
Prefix:
First Name:EVENIE
Middle Name:FRANTZDIA
Last Name:MIRALLES
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8725 AZALEA CT APT 203
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2043
Mailing Address - Country:US
Mailing Address - Phone:786-930-8181
Mailing Address - Fax:
Practice Address - Street 1:8725 AZALEA CT APT 203
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2043
Practice Address - Country:US
Practice Address - Phone:786-930-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health