Enobong Ettang, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP2014862 Issued in FL

Practice address

3090 SW 37TH Ave
Miami, FL 33133-4311

Phone

(305) 351-1320

Fax

(305) 444-7866

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1336217314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 SW 37TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334311",
            "telephone_number": "305-351-1320",
            "fax_number": "305-444-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 SW 37TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334311",
            "telephone_number": "305-351-1320",
            "fax_number": "305-444-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTANG",
        "first_name": "ENOBONG",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2014862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307858200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.