Provider Demographics
NPI:1053749069
Name:GANEM, KATHERINE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:GANEM
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 1:14221 SW 120TH ST STE 132
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7463
Mailing Address - Country:US
Mailing Address - Phone:786-845-6463
Mailing Address - Fax:786-723-6784
Practice Address - Street 1:14221 SW 120TH ST STE 132
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7463
Practice Address - Country:US
Practice Address - Phone:786-845-6463
Practice Address - Fax:786-723-6784
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9344697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily