Healthcare Provider Details

I. General information

NPI: 1770063745
Provider Name (Legal Business Name): RENE LEYVA QUEVEDO ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2018
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5849 OKEECHOBEE BLVD STE 301
WEST PALM BEACH FL
33417-4352
US

IV. Provider business mailing address

5827 CORPORATE WAY
WEST PALM BEACH FL
33407-2000
US

V. Phone/Fax

Practice location:
  • Phone: 561-683-4008
  • Fax: 877-278-3166
Mailing address:
  • Phone: 561-844-9443
  • Fax: 561-472-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9397918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: