Jacklyn Reyes Pancrudo
Critical Care Medicine
11750 Sw 40th St
Miami
, Florida 33175-3530
Jacklyn Reyes Pancrudo
Critical Care Medicine
11750 Sw 40th St
Miami
, Florida 33175-3530
(561) 997-0821
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About
Features
Specialties
- Critical Care Medicine
Languages spoken
- English
Location
First Address
- Jacklyn Reyes Pancrudo
- 1875 Nw Corporate Blvd Suite 270
- Boca Raton, FL
- Zip : 33431-8542
- Phone : (561) 997-0821
Second Address
- Jacklyn Reyes Pancrudo
- 11750 Sw 40th St
- Miami, FL
- Zip : 33175-3530
- Phone : (561) 997-0821
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0200X | Critical Care Medicine | OS11255 | FL |
National Provider Identifier
| NPI | 1003046962 |
|---|---|
| Provider Name | Jacklyn Reyes Pancrudo |
| First Address | Boca Raton, FL 33431-8542 |
| Second Address | Miami, FL 33175-3530 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/07/2009 |
| Last Update Date | 27/01/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.