Individual
JEANNINE ANTONELLA ICAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1240 S DIXIE HWY, CORAL GABLES, FL 33146-2902
(305) 669-2833
Mailing address
10273 SW 116TH ST # AT, MIAMI, FL 33176-4047
(786) 218-6613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11005030
FL
Other
Enumeration date
04/08/2024
Last updated
05/13/2024
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