Healthcare Provider Details

I. General information

NPI: 1376072249
Provider Name (Legal Business Name): VICTOR VAPOR-CUI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VICTOR REY VAPOR DNP, APRN

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 09/26/2022
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12056 SCARSDALE DR
JACKSONVILLE FL
32246-9331
US

IV. Provider business mailing address

12056 SCARSDALE DR
JACKSONVILLE FL
32246-9331
US

V. Phone/Fax

Practice location:
  • Phone: 904-400-2960
  • Fax:
Mailing address:
  • Phone: 904-400-2960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number828427
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN9376012
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: