Healthcare Provider Details

I. General information

NPI: 1679937809
Provider Name (Legal Business Name): JOAQUIN RENDON DE ARMAS M.S.N, NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 NW 41ST ST
DORAL FL
33166-6202
US

IV. Provider business mailing address

13271 SW 17TH LN APT 5
MIAMI FL
33175-7650
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-5366
  • Fax: 305-644-6407
Mailing address:
  • Phone: 305-986-6257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9341074
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: