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NPI Code Detail

MEDICARE: SUSANA REYES ALEJO

MEDICARE: SUSANA REYES ALEJO
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
1174H00000XHealth Educator

General Provider Information

NPI Number : 1659870152
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANA REYES ALEJO
Provider Business Mailing Address
First Line : 19731 MORDEN BLUSH DR
Second Line :
City : LUTZ
State : FL
Zip : 33558-9089
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 E OAK AVE
Second Line :
City : TAMPA
State : FL
Zip : 33602-2210
Country : US
Telephone Number : 813-224-9622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2018
Last Update Date : 02/09/2018

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Directions to “ SUSANA REYES ALEJO ” Practice Location

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