Provider Demographics
NPI:1467544270
Name:RIGUEZ, JANNELLE M (ARNP)
Entity Type:Individual
Prefix:
First Name:JANNELLE
Middle Name:M
Last Name:RIGUEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4770 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 780
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3202
Mailing Address - Country:US
Mailing Address - Phone:786-268-8289
Mailing Address - Fax:786-268-4561
Practice Address - Street 1:4770 BISCAYNE BLVD
Practice Address - Street 2:SUITE 780
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3202
Practice Address - Country:US
Practice Address - Phone:786-268-8289
Practice Address - Fax:786-268-4561
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2681452363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5706ZMedicare PIN
FLS48033Medicare UPIN