Provider Demographics
NPI:1588428072
Name:TELLEZ, ROBIN DENISE (RN, NC-BC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:DENISE
Last Name:TELLEZ
Suffix:
Gender:F
Credentials:RN, NC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12010 SW 187TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3233
Mailing Address - Country:US
Mailing Address - Phone:178-654-3350
Mailing Address - Fax:
Practice Address - Street 1:12010 SW 187TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-3233
Practice Address - Country:US
Practice Address - Phone:178-654-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1192482171400000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach