Individual
MAIKEL Y PORTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
6740 SW 16TH ST, MIAMI, FL 33155-1708
(305) 316-9812
Mailing address
6740 SW 16TH ST, MIAMI, FL 33155-1708
(305) 316-9812
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11002841
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11002841
FL
Other
Enumeration date
01/16/2020
Last updated
06/18/2022
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