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General NPI Number Information
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NPI Number | 1609884253
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Entity Type | Individual
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Provider Name | REELI REINU PA
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2600 LAKE LUCIEN DR STE 180
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City | MAITLAND
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State | FL
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Zip | 32751-7235
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Country | US
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Telephone | 407-875-2080
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Fax | 407-875-0518
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Provider Business Mailing Address
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Address Line | 1768 PARK CENTER DR STE 300
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City | ORLANDO
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State | FL
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Zip | 32835-6256
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Country | US
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Telephone | 407-445-9445
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Fax | 407-293-3908
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9102028
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License Number State | FL
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