Provider Demographics
NPI:1831600451
Name:BOTERO, MARIA CECILIA (ARNP)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CECILIA
Last Name:BOTERO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CECILIA
Other - Last Name:BOTERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1255 PENNSYLVANIA AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-4497
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1120 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2107
Practice Address - Country:US
Practice Address - Phone:305-243-2279
Practice Address - Fax:305-243-8108
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9351455363LF0000X
FLAPRN9351455363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily