Healthcare Provider Details

I. General information

NPI: 1487495537
Provider Name (Legal Business Name): NOHELYM DE FATIMA RODRIGUEZ ALONZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 N AMERICA WAY
MIAMI FL
33132-2017
US

IV. Provider business mailing address

340 HIALEAH DR
HIALEAH FL
33010-5221
US

V. Phone/Fax

Practice location:
  • Phone: 305-358-4265
  • Fax:
Mailing address:
  • Phone: 786-236-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number11030554
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: