Healthcare Provider Details

I. General information

NPI: 1366291999
Provider Name (Legal Business Name): YOEL MADRUGA REYES APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5503 S CONGRESS AVE STE 205
ATLANTIS FL
33462-6626
US

IV. Provider business mailing address

5503 S CONGRESS AVE STE 205
ATLANTIS FL
33462-6626
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-7228
  • Fax: 561-766-1278
Mailing address:
  • Phone: 561-965-7228
  • Fax: 561-766-1278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11032821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: