Provider Demographics
NPI:1619486792
Name:TRETO, ENRIQUE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:TRETO
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SW 116TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3704
Mailing Address - Country:US
Mailing Address - Phone:786-923-7188
Mailing Address - Fax:
Practice Address - Street 1:601 SW 116TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3704
Practice Address - Country:US
Practice Address - Phone:786-923-7188
Practice Address - Fax:786-923-7188
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9366718363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily