Provider Demographics
NPI:1902058415
Name:DEPIOLA, PAMELA REGINA (ARNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:REGINA
Last Name:DEPIOLA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19559 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3501
Mailing Address - Country:US
Mailing Address - Phone:305-651-3261
Mailing Address - Fax:
Practice Address - Street 1:16401 NW 2ND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-6036
Practice Address - Country:US
Practice Address - Phone:305-999-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1328792363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health