MEDICARE: ANITA SUSAN REYES FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9263558	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033697776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA SUSAN REYES FNP

Provider Business Mailing Address
First Line	:	7931 OLYMPIA DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-5788
Country	:	US
Telephone Number	:	561-373-2540
Fax Number	:	561-855-7293

Provider Business Practice Location Address
First Line	:	11327 OKEECHOBEE BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-8724
Country	:	US
Telephone Number	:	561-340-1615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2018
Last Update Date	:	11/17/2021

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