Healthcare Provider Details

I. General information

NPI: 1770940934
Provider Name (Legal Business Name): MARIA ELENA RENDON DE DAHER RN,MW,SA-C, EO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 12/14/2019
Certification Date: 12/14/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST
HIALEAH FL
33013-3825
US

IV. Provider business mailing address

10936 NW 67TH ST
DORAL FL
33178-3744
US

V. Phone/Fax

Practice location:
  • Phone: 305-693-3535
  • Fax:
Mailing address:
  • Phone: 786-514-8272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9470901
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number343
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number3246
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number14-346
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP11004836
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11004836
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: