Individual
NANCY PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15062 SW 30TH ST, MIAMI, FL 33185-4853
(305) 562-2847
Mailing address
15062 SW 30TH ST, MIAMI, FL 33185-4853
(305) 562-2847
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
9253104
FL
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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