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Individual

MRS. FANNY YADIRA GALLANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6531
Mailing address
7800 SW 132ND AVE, MIAMI, FL 33183-4269
(305) 386-9285

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9166176
FL
363LA2200X
Adult Health Nurse Practitioner
9166176
FL

Other

Enumeration date
09/10/2009
Last updated
02/20/2020
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