Maikel Aguila Deustua, ARPN

Individual provider Active NPI Family Nurse Practitioner · Homestead, FL

NPI 1689370421 · NPPES record last updated Feb 2, 2023

Key facts

NPI
1689370421
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
11012521 (FL)
Practice address
23625 SW 113TH Psge
Homestead, FL 33032-7134
Phone
(305) 764-7158
NPI assigned
Feb 2, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11012521FLMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 11012521 FL Yes

Addresses

Primary practice location

23625 SW 113TH Psge
Homestead, FL 33032-7134

Mailing address

23625 SW 113TH Psge
Homestead, FL 33032-7134
Phone (305) 764-7158

Other providers in Homestead, FL

All providers in Homestead, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.