Healthcare Provider Details

I. General information

NPI: 1457260150
Provider Name (Legal Business Name): DAPHNEE PAUL RENTERIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16289 SEA TURTLE PL
WESTLAKE FL
33470-3313
US

IV. Provider business mailing address

16289 SEA TURTLE PL
WESTLAKE FL
33470-3313
US

V. Phone/Fax

Practice location:
  • Phone: 954-234-4871
  • Fax:
Mailing address:
  • Phone: 954-234-4871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF409028-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: