MEDICARE: NINA RENE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	654219	NY
2	163W00000X	Registered Nurse	RN9666339	FL

General Provider Information

NPI Number	:	1215294095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA RENE

Provider Business Mailing Address
First Line	:	303 S FEDERAL HWY APT 1607
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-5759
Country	:	US
Telephone Number	:	718-415-2157
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 S FEDERAL HWY
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-5651
Country	:	US
Telephone Number	:	718-415-2157
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	07/02/2026

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Directions to “ NINA RENE ” Practice Location

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