Provider Demographics
NPI:1114574704
Name:JURE REYES, RAFAEL (RN)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:
Last Name:JURE REYES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5231 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5025
Mailing Address - Country:US
Mailing Address - Phone:786-398-2293
Mailing Address - Fax:
Practice Address - Street 1:5231 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5025
Practice Address - Country:US
Practice Address - Phone:786-398-2293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9507855163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse