Healthcare Provider Details

I. General information

NPI: 1699631531
Provider Name (Legal Business Name): ADRIANA LLERENA REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 KAPOK TREE CT
SPRING HILL FL
34606-6710
US

IV. Provider business mailing address

3423 KAPOK TREE CT
SPRING HILL FL
34606-6710
US

V. Phone/Fax

Practice location:
  • Phone: 813-678-3297
  • Fax:
Mailing address:
  • Phone: 813-678-3297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number25494163
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: