Individual
JOHANNYS BERGOLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1381 W 30TH ST, HIALEAH, FL 33012-4853
(305) 989-5518
Mailing address
1381 W 30TH ST, HIALEAH, FL 33012-4853
(305) 989-5518
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11038862
FL
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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