Provider Demographics
NPI:1851760060
Name:ANDINO RIOS, NELSON (APRN)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:
Last Name:ANDINO RIOS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15373 SW 178TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-7723
Mailing Address - Country:US
Mailing Address - Phone:786-768-4459
Mailing Address - Fax:
Practice Address - Street 1:1469 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5557
Practice Address - Country:US
Practice Address - Phone:305-635-7444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9312213363LF0000X
FLAPRN9312213363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9312213OtherFLORIDA HEALTH DEPARTMENT
FL101126900Medicaid