Provider Demographics
NPI:1609492685
Name:CARDENAS, LUIS ALBERTO (APRN)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ALBERTO
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 SW 39TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4820
Mailing Address - Country:US
Mailing Address - Phone:305-879-6834
Mailing Address - Fax:
Practice Address - Street 1:139 N REDLAND RD STE 5
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3105
Practice Address - Country:US
Practice Address - Phone:305-269-7887
Practice Address - Fax:786-650-2968
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily