MEDICARE: JAIME LYNNE REYES APRN, FNP-C

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	APRN11004563	FL

General Provider Information

NPI Number	:	1831860378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME LYNNE REYES APRN, FNP-C

Provider Business Mailing Address
First Line	:	7447 CLEVELAND ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5325
Country	:	US
Telephone Number	:	954-263-8692
Fax Number	:

Provider Business Practice Location Address
First Line	:	7447 CLEVELAND ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5325
Country	:	US
Telephone Number	:	954-263-8692
Fax Number	:

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

Provider Enumeration Date	:	09/24/2021
Last Update Date	:	09/24/2021

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