Provider Demographics
NPI:1023406717
Name:RANIERE, AIDAN (FNP-C)
Entity type:Individual
Prefix:
First Name:AIDAN
Middle Name:
Last Name:RANIERE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 NE 62ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2163
Mailing Address - Country:US
Mailing Address - Phone:214-727-3711
Mailing Address - Fax:
Practice Address - Street 1:789 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1218
Practice Address - Country:US
Practice Address - Phone:954-315-5784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0108940363LF0000X
FLARNP9453518363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021220100Medicaid
VT1024338Medicaid