Provider Demographics
NPI:1366291999
Name:MADRUGA REYES, YOEL (APRN)
Entity type:Individual
Prefix:
First Name:YOEL
Middle Name:
Last Name:MADRUGA REYES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 S CONGRESS AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6626
Mailing Address - Country:US
Mailing Address - Phone:561-965-7228
Mailing Address - Fax:561-766-1278
Practice Address - Street 1:5503 S CONGRESS AVE STE 205
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6626
Practice Address - Country:US
Practice Address - Phone:561-965-7228
Practice Address - Fax:561-766-1278
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily