Provider Demographics
NPI:1144826538
Name:REY, GLORIA LUCY (APRN)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:LUCY
Last Name:REY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8260 W FLAGLER ST STE 1J
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2069
Mailing Address - Country:US
Mailing Address - Phone:305-223-2464
Mailing Address - Fax:305-223-9886
Practice Address - Street 1:8260 W FLAGLER ST STE 1J
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:305-223-2464
Practice Address - Fax:305-223-9886
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily