Individual
AERA JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-1111
Mailing address
10110 SW 85TH ST, MIAMI, FL 33173-3919
(786) 899-6227
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APRN9396939
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN9396939
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN9396939
FLORIDA NURSING BOARD
FL
Enumeration date
12/16/2018
Last updated
05/13/2021
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