Healthcare Provider Details

I. General information

NPI: 1497362024
Provider Name (Legal Business Name): KYLIENE REYES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 S PINE AVE
OCALA FL
34471-6522
US

IV. Provider business mailing address

1219 S PINE AVE STE 204
OCALA FL
34471-6524
US

V. Phone/Fax

Practice location:
  • Phone: 352-354-9000
  • Fax: 352-620-0255
Mailing address:
  • Phone: 352-354-9000
  • Fax: 352-620-0255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11010406
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: