Basic Information
Provider Information
NPI: 1932650413
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEMP
FirstName: CARIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 1400 NW 12TH AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331361003
CountryCode: US
TelephoneNumber: 3053255511
FaxNumber:  
Practice Location
Address1: 1400 NW 12TH AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331361003
CountryCode: US
TelephoneNumber: 3053255511
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/19/2016
LastUpdateDate: 01/24/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XARNP9364631FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000XAPRN9364631FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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