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NPI Code Detail

MEDICARE: NELLIE ESTHER RENDON LMT

MEDICARE:   NELLIE ESTHER RENDON  LMT
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
1174400000XSpecialistMA0012117FL

General Provider Information

NPI Number : 1891703062
Entity Type Code : Individual
Provider Name (Legal Business Name) : NELLIE ESTHER RENDON LMT
Provider Business Mailing Address
First Line : 2774 POINTE CIR
Second Line :
City : GREENACRES
State : FL
Zip : 33413-2153
Country : US
Telephone Number : 561-439-3262
Fax Number :
Provider Business Practice Location Address
First Line : 2072 S MILITARY TRL
Second Line : SUITE 7
City : WEST PALM BEACH
State : FL
Zip : 33415-6419
Country : US
Telephone Number : 561-965-5500
Fax Number : 561-965-5592
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 07/08/2007

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Directions to “ NELLIE ESTHER RENDON LMT” Practice Location

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