Provider Demographics
NPI:1770252603
Name:RODRIGUEZ RUNYON, LIANA (APRN)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:RODRIGUEZ RUNYON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8021 PETERS RD APT 147
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4056
Mailing Address - Country:US
Mailing Address - Phone:786-853-9862
Mailing Address - Fax:
Practice Address - Street 1:1821 WIRT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-2406
Practice Address - Country:US
Practice Address - Phone:713-468-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily