Provider Demographics
NPI:1437513132
Name:REAVES, LURENA
Entity Type:Individual
Prefix:
First Name:LURENA
Middle Name:
Last Name:REAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1631 ROCK SPRINGS RD STE 371
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2229
Mailing Address - Country:US
Mailing Address - Phone:407-285-5014
Mailing Address - Fax:
Practice Address - Street 1:1631 ROCK SPRINGS RD STE 371
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2229
Practice Address - Country:US
Practice Address - Phone:407-285-5014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health