Provider Demographics
NPI:1508404708
Name:CONTRERAS RODRIGUEZ, DULIEN (NP)
Entity Type:Individual
Prefix:
First Name:DULIEN
Middle Name:
Last Name:CONTRERAS RODRIGUEZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 SW 72ND ST STE 112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3245
Mailing Address - Country:US
Mailing Address - Phone:786-343-0551
Mailing Address - Fax:786-323-7386
Practice Address - Street 1:9350 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3286
Practice Address - Country:US
Practice Address - Phone:786-343-0551
Practice Address - Fax:786-590-1866
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005271363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1114485638OtherUNITED
FL1114485638Medicaid
FL1114485638OtherAETNA