Provider Demographics
NPI:1386493823
Name:RODRIGUEZ MORENO, DARIANNA
Entity type:Individual
Prefix:
First Name:DARIANNA
Middle Name:
Last Name:RODRIGUEZ MORENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10726 SW 147TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2479
Mailing Address - Country:US
Mailing Address - Phone:201-428-5728
Mailing Address - Fax:
Practice Address - Street 1:10726 SW 147TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2479
Practice Address - Country:US
Practice Address - Phone:201-428-5728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC53341A4B163WH0200X
FL251E00000X
251E00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No251E00000XAgenciesHome Health