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General NPI Number Information
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NPI Number | 1023361441
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Entity Type | Organization
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Legal Business Name | REBECCA REYNOLDS ARNP
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 9035 PARK BLVD
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City | SEMINOLE
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State | FL
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Zip | 33777-4130
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Country | US
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Telephone | 727-244-5086
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Fax | 877-422-2920
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Provider Business Mailing Address
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Address Line | 9035 PARK BLVD
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City | SEMINOLE
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State | FL
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Zip | 33777-4130
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Country | US
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Telephone | 727-244-5086
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Fax | 877-422-2920
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA REYNOLDS
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Credential | ARNP
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Telephone | 727-244-5086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP2736202
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License Number State | FL
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