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General NPI Number Information
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NPI Number | 1083360630
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Entity Type | Individual
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Provider Name | RENNY DE LA CARIDAD MESA RIVERO
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Gender | Male
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2695 S LE JEUNE RD STE 300
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City | CORAL GABLES
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State | FL
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Zip | 33134-5840
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Country | US
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Telephone | 305-446-0330
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Fax | 305-446-5079
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Provider Business Mailing Address
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Address Line | 1048 SE 24TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33035-2140
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Country | US
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Telephone | 786-368-8121
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11016707
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License Number State | FL
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