Provider Demographics
NPI:1669012431
Name:EXPOSITO, RENE ALCIDES (APRN)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:ALCIDES
Last Name:EXPOSITO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 49106
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33743-9106
Mailing Address - Country:US
Mailing Address - Phone:727-269-5618
Mailing Address - Fax:727-265-3420
Practice Address - Street 1:13021 W LINEBAUGH AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4509
Practice Address - Country:US
Practice Address - Phone:813-709-8567
Practice Address - Fax:215-309-9490
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2025-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL11005630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7HMIFOtherBLUE CROS BLUE SHIELD
FL109483200Medicaid