Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN11004705 | FL |
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN11004705 | FL |
NPI | 1023668829 |
---|---|
Provider Name | Amilcar Rey |
First Address | South Miami, FL 33143-4828 |
Second Address | South Miami, FL 33143-4679 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2019 |
Last Update Date | 09/04/2020 |