Provider Demographics
NPI:1417712266
Name:RIJOS PADRON, LUIS ALEXANDER (RN)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALEXANDER
Last Name:RIJOS PADRON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 NW 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4924
Mailing Address - Country:US
Mailing Address - Phone:813-774-2368
Mailing Address - Fax:
Practice Address - Street 1:275 NW 33RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4924
Practice Address - Country:US
Practice Address - Phone:813-774-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9379901163W00000X
FL001717163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool