Provider Demographics
NPI:1982295085
Name:JARAMILLO, VIVIANA ALEXANDRA (LM)
Entity Type:Individual
Prefix:MS
First Name:VIVIANA
Middle Name:ALEXANDRA
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6703
Mailing Address - Country:US
Mailing Address - Phone:954-925-4499
Mailing Address - Fax:
Practice Address - Street 1:2316 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6703
Practice Address - Country:US
Practice Address - Phone:954-925-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife