Individual
BANIA PEDRAJA FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9250 NW 36TH ST STE 420, DORAL, FL 33178-2775
(305) 266-2929
Mailing address
5000 NW 183RD ST, MIAMI GARDENS, FL 33055-2929
(786) 985-1635
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11012973
FL
Other
Enumeration date
04/07/2021
Last updated
04/27/2023
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