Individual
BEATRIZ BACALLAO RAVELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6100 SW 114TH AVE, MIAMI, FL 33173-1084
(305) 439-3778
Mailing address
6100 SW 114TH AVE, MIAMI, FL 33173-1084
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
11028983
FL
363LF0000X
Family Nurse Practitioner
Primary
11028983
FL
Other
Enumeration date
10/02/2023
Last updated
03/05/2026
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