Healthcare Provider Details

I. General information

NPI: 1497675201
Provider Name (Legal Business Name): REGINO ISRAEL SARMIENTO REYES APRN-FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S PARSONS AVE
BRANDON FL
33511-6007
US

IV. Provider business mailing address

7610 RUSTIC DR
TAMPA FL
33634-2251
US

V. Phone/Fax

Practice location:
  • Phone: 813-280-4909
  • Fax:
Mailing address:
  • Phone: 786-702-5081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07261079
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: