Healthcare Provider Details

I. General information

NPI: 1689049041
Provider Name (Legal Business Name): REYNALD JEAN ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8175 NW 12TH ST STE 306
DORAL FL
33126
US

IV. Provider business mailing address

15281 SW 51ST ST
MIRAMAR FL
33027-3608
US

V. Phone/Fax

Practice location:
  • Phone: 786-845-0164
  • Fax: 305-470-5846
Mailing address:
  • Phone: 954-662-5286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9281306
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9281306
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: