Healthcare Provider Details

I. General information

NPI: 1851760060
Provider Name (Legal Business Name): NELSON ANDINO RIOS APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 NW 36TH ST
MIAMI FL
33142-5557
US

IV. Provider business mailing address

15373 SW 178TH ST
MIAMI FL
33187-7723
US

V. Phone/Fax

Practice location:
  • Phone: 305-635-7444
  • Fax:
Mailing address:
  • Phone: 786-768-4459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9312213
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9312213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: