Healthcare Provider Details

I. General information

NPI: 1205588563
Provider Name (Legal Business Name): RIANA REID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5997 S GOLDENROD RD
ORLANDO FL
32822-8775
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 407-856-1900
  • Fax: 407-856-2389
Mailing address:
  • Phone: 844-630-0700
  • Fax: 877-374-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11041784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: