Provider Demographics
NPI:1144845314
Name:ZALDIVAR, JESSICA-LYNN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA-LYNN
Middle Name:
Last Name:ZALDIVAR
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14575 NW 77TH AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2549
Mailing Address - Country:US
Mailing Address - Phone:786-474-4447
Mailing Address - Fax:
Practice Address - Street 1:14575 NW 77TH AVE STE 304
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2549
Practice Address - Country:US
Practice Address - Phone:786-474-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9254344163WP0808X
FLAPRN11007523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health