Basic Information
Provider Information
NPI: 1215543947
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRONG
FirstName: NAOMI
MiddleName: SARAH
NamePrefix: MISS
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3100 SW 62ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331553009
CountryCode: US
TelephoneNumber: 3056666511
FaxNumber:  
Practice Location
Address1: 3100 SW 62ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331553009
CountryCode: US
TelephoneNumber: 3056666511
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/17/2020
LastUpdateDate: 12/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WG0000X9273018FLN Nursing Service ProvidersRegistered NurseGeneral Practice
363L00000X11006604FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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