Healthcare Provider Details

I. General information

NPI: 1205414729
Provider Name (Legal Business Name): ADDYS DEL CARMEN REVE URGELLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 TAMIAMI TRL N STE 25
NAPLES FL
34103-3065
US

IV. Provider business mailing address

270 MADISON DR
NAPLES FL
34110-1326
US

V. Phone/Fax

Practice location:
  • Phone: 239-423-0272
  • Fax: 239-423-0292
Mailing address:
  • Phone: 239-423-0272
  • Fax: 239-423-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME163785
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME163785
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: