Provider Demographics
NPI:1376392290
Name:FUENTES RODRIGUEZ, COSETTE (FNP-C)
Entity type:Individual
Prefix:
First Name:COSETTE
Middle Name:
Last Name:FUENTES RODRIGUEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13707 SW 66TH ST APT 103C
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2208
Mailing Address - Country:US
Mailing Address - Phone:786-805-8772
Mailing Address - Fax:
Practice Address - Street 1:13707 SW 66TH ST APT 103C
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2208
Practice Address - Country:US
Practice Address - Phone:786-805-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily