Provider Demographics
NPI:1477880466
Name:MENESES, RENE A (MSPT)
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:A
Last Name:MENESES
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 S DIXIE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2462
Mailing Address - Country:US
Mailing Address - Phone:305-860-8363
Mailing Address - Fax:
Practice Address - Street 1:2150 S DIXIE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2462
Practice Address - Country:US
Practice Address - Phone:305-860-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist