Provider Demographics
NPI:1316592298
Name:MESTRE, RAFAEL (APRN)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:MESTRE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14680 SW 8TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3138
Mailing Address - Country:US
Mailing Address - Phone:305-549-8937
Mailing Address - Fax:786-801-0880
Practice Address - Street 1:9589 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2914
Practice Address - Country:US
Practice Address - Phone:305-629-9914
Practice Address - Fax:305-592-0453
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily