Healthcare Provider Details

I. General information

NPI: 1669835112
Provider Name (Legal Business Name): REYNALDO E ARRIETA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 US HIGHWAY 19 N
PINELLAS PARK FL
33781-4600
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 400
MIAMI FL
33126-2051
US

V. Phone/Fax

Practice location:
  • Phone: 727-373-4401
  • Fax:
Mailing address:
  • Phone: 305-500-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11016387
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9500673
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: