Provider Demographics
NPI:1801778675
Name:FUENTES, SANDRA (NP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:FUENTES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8731 SW 192ND TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8954
Mailing Address - Country:US
Mailing Address - Phone:786-909-8463
Mailing Address - Fax:305-723-2777
Practice Address - Street 1:12485 SW 137TH AVE STE 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4217
Practice Address - Country:US
Practice Address - Phone:786-909-8463
Practice Address - Fax:305-723-2777
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9448537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily