Provider Demographics
NPI:1437882057
Name:REYNA TREVINO, DANIELA (PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:REYNA TREVINO
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:REYNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2916 MAGNOLIA BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7522
Mailing Address - Country:US
Mailing Address - Phone:832-266-2627
Mailing Address - Fax:
Practice Address - Street 1:2916 MAGNOLIA BLOSSOM CIR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7522
Practice Address - Country:US
Practice Address - Phone:832-266-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLK5K8B8N9246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory