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: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9955 TAMIAMI TRL N STE 2
NAPLES FL
34108-1914
US

IV. Provider business mailing address

9955 TAMIAMI TRL N STE 2
NAPLES FL
34108-1914
US

V. Phone/Fax

Practice location:
  • Phone: 239-423-0205
  • Fax: 239-423-0206
Mailing address:
  • Phone: 239-423-0205
  • Fax: 239-423-0206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: