Provider Demographics
NPI:1235880071
Name:REUTLINGER, JUNIET
Entity Type:Individual
Prefix:
First Name:JUNIET
Middle Name:
Last Name:REUTLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 SW 108TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1229
Mailing Address - Country:US
Mailing Address - Phone:305-764-2194
Mailing Address - Fax:
Practice Address - Street 1:1200 S PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4413
Practice Address - Country:US
Practice Address - Phone:646-612-7782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY684438163W00000X
FLRN9418136163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse