Provider Demographics
NPI:1841825429
Name:VIVES, NATASHA (ARNP)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:VIVES
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 1:12723 NW 6TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1100
Mailing Address - Country:US
Mailing Address - Phone:305-227-1579
Mailing Address - Fax:
Practice Address - Street 1:330 SAN LORENZO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1846
Practice Address - Country:US
Practice Address - Phone:305-428-2593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine