Provider Demographics
NPI:1386987626
Name:REXACH, DOLORES C (ARNP)
Entity type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:C
Last Name:REXACH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6263 SW 162ND PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4465
Mailing Address - Country:US
Mailing Address - Phone:786-488-3956
Mailing Address - Fax:305-408-9524
Practice Address - Street 1:8200 NW 41ST ST STE 300
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6204
Practice Address - Country:US
Practice Address - Phone:786-488-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3165812363LF0000X
FL3165812363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily