Individual
JOSE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15641 SW 8TH LN, MIAMI, FL 33194-2409
(786) 487-6204
Mailing address
15641 SW 8TH LN, MIAMI, FL 33194-2409
(786) 487-6204
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9255431
FL
363LF0000X
Family Nurse Practitioner
ARNP9255431
FL
Other
Enumeration date
10/07/2014
Last updated
09/20/2017
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