Provider Demographics
NPI:1740603141
Name:RODRIGUEZ ELIAS, RENE BELTRAN (FNP)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:BELTRAN
Last Name:RODRIGUEZ ELIAS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 W 56TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6903
Mailing Address - Country:US
Mailing Address - Phone:305-200-1225
Mailing Address - Fax:305-200-1883
Practice Address - Street 1:915 W 49TH ST STE 101
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3412
Practice Address - Country:US
Practice Address - Phone:305-528-2780
Practice Address - Fax:305-200-1183
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9365354363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care