Provider Demographics
NPI:1821106527
Name:PAEZ, RENE A (MD)
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:A
Last Name:PAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7300 SW 62ND PL FL 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4800
Mailing Address - Country:US
Mailing Address - Phone:305-665-1133
Mailing Address - Fax:305-666-0258
Practice Address - Street 1:7300 SW 62ND PL
Practice Address - Street 2:3 FL
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4806
Practice Address - Country:US
Practice Address - Phone:305-665-1133
Practice Address - Fax:305-666-0258
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78759174400000X, 207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH34605Medicare UPIN