Healthcare Provider Details

I. General information

NPI: 1730066093
Provider Name (Legal Business Name): LISBET REYES LORENZO MSN, APRN,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 BOLADO PKWY
CAPE CORAL FL
33990-2712
US

IV. Provider business mailing address

2307 BOLADO PKWY
CAPE CORAL FL
33990-2712
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-8122
  • Fax:
Mailing address:
  • Phone: 239-424-8122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11041664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: