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Individual

SHELLY DUPERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
350 NE 167TH ST, MIAMI, FL 33162-2303
(786) 378-2752
Mailing address
1260 NW 155TH LN APT 105, MIAMI, FL 33169-6308
(786) 378-2752

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5234638
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D160-780-80-634-0
ID
FL
Enumeration date
01/18/2019
Last updated
01/18/2019
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