Provider Demographics
NPI:1083375786
Name:BARROSO REINA, HECTOR (APRN - FNP)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:
Last Name:BARROSO REINA
Suffix:
Gender:M
Credentials:APRN - FNP
Other - Prefix:MR
Other - First Name:HECTOR
Other - Middle Name:
Other - Last Name:BARROSO REINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN - FNP
Mailing Address - Street 1:252 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4312
Mailing Address - Country:US
Mailing Address - Phone:727-310-5179
Mailing Address - Fax:
Practice Address - Street 1:252 W 35TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4312
Practice Address - Country:US
Practice Address - Phone:727-310-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11017265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily