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General NPI Number Information
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NPI Number | 1700681038
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Entity Type | Individual
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Provider Name | FANIA REYES APRN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 8950 SW 152ND ST STE 103
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City | PALMETTO BAY
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State | FL
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Zip | 33157-2066
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Country | US
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Telephone | 786-596-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 16101 SW 277TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33031-2948
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Country | US
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Telephone | 786-343-0203
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11037712
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License Number State | FL
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