Basic Information
| Provider Information | |||||||||
| NPI: | 1619408101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARRION | ||||||||
| FirstName: | JESSICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10031 WINDING LAKE RD APT 102 | ||||||||
| Address2: | |||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333515856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549185533 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1120 NW 14TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052437014 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2017 | ||||||||
| LastUpdateDate: | 03/25/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP9311554 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.