Healthcare Provider Details

I. General information

NPI: 1831909985
Provider Name (Legal Business Name): MAYELIN PEREZ REINA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 58TH ST N
SAINT PETERSBURG FL
33710-6325
US

IV. Provider business mailing address

960 58TH ST N
SAINT PETERSBURG FL
33710-6325
US

V. Phone/Fax

Practice location:
  • Phone: 727-820-7778
  • Fax: 727-820-7779
Mailing address:
  • Phone: 727-820-7778
  • Fax: 727-820-7779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11037447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: