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General NPI Number Information
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NPI Number | 1881168359
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Entity Type | Individual
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Provider Name | ANA LUISA REY MEDINA APRN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 4623 FOREST HILL BLVD STE 112
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-9121
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Country | US
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Telephone | 561-433-0080
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Fax | 561-433-1668
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Provider Business Mailing Address
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Address Line | 6710 OSAGE CIR
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City | GREENACRES
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State | FL
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Zip | 33413-3479
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Country | US
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Telephone | 305-713-5796
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11000458
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11000458
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License Number State | FL
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