Healthcare Provider Details

I. General information

NPI: 1235997180
Provider Name (Legal Business Name): ARELIS MERCEDES REYNA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 03/06/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB VERSALLES CALLE 5 E17
BAYAMON PR
00959-2111
US

IV. Provider business mailing address

URB VERSALLES CALLE 5 E17
BAYAMON PR
00959-2111
US

V. Phone/Fax

Practice location:
  • Phone: 787-533-2407
  • Fax:
Mailing address:
  • Phone: 787-533-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number72088
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: