Individual
GRISEL IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3700 COMMERCE PKWY, MIRAMAR, FL 33025-3912
(844) 215-4264
(844) 215-4265
Mailing address
6712 NW 193RD TER, HIALEAH, FL 33015-2454
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5162243
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN5162243
LPN LICENSE
FL
Enumeration date
04/05/2016
Last updated
04/05/2016
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