Provider Demographics
NPI:1508300963
Name:LONGINI, RENEE (DNP, CRNA)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:LONGINI
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ANTIQUERA AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3044
Mailing Address - Country:US
Mailing Address - Phone:609-501-6280
Mailing Address - Fax:
Practice Address - Street 1:127 ANTIQUERA AVE APT 9
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3044
Practice Address - Country:US
Practice Address - Phone:609-501-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9295252367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered