Provider Demographics
NPI:1255938437
Name:RODRIGUEZ, NESTOR EDILIO (ARNP)
Entity type:Individual
Prefix:
First Name:NESTOR
Middle Name:EDILIO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14510 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3789
Mailing Address - Country:US
Mailing Address - Phone:786-417-4793
Mailing Address - Fax:
Practice Address - Street 1:290 NW 165TH ST STE P100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6470
Practice Address - Country:US
Practice Address - Phone:305-889-1884
Practice Address - Fax:305-949-0586
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily