Individual ProviderSasha GranadilloNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7300 SW 62nd Pl Fl 4, South Miami, FL 33143-4800(305) 662-7901(786) 290-6600PECOS EnrollmentBased on the most recent information from CMS, provider Sasha Granadillo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1245798800Provider TypeIndividualFull NameGranadillo, SashaCredentialAPRN, FNP-BCGenderFemaleSole ProprietorYesEnumeration Date3/3/2019Last Updated2/22/2021Contact InformationPractice LocationPractice Address7300 SW 62nd Pl Fl 4, South Miami, FL 33143-4800Phone(305) 662-7901FaxUnlisted FaxMailing LocationMailing AddressPO Box 770133, Miami, FL 33177-0003Phone(786) 290-6600FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11001067FloridaCode207VE0102XDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicenseAPRN11001067Florida