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General NPI Number Information
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NPI Number | 1669006748
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Entity Type | Individual
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Provider Name | ANDREA REYES
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Gender | Female
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 10/05/2024
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Provider Practice Location Address
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Address Line | 3133 W VILLA ROSA ST
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City | TAMPA
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State | FL
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Zip | 33611-2943
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Country | US
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Telephone | 740-350-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 2590 HEALING WAY STE 310
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5497
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Country | US
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Telephone |
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11006198
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License Number State | FL
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