Provider Demographics
NPI:1821306317
Name:RENO, LETICIA B (MD)
Entity Type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:B
Last Name:RENO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:9471 BAYMEADOWS RD STE 405
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7937
Mailing Address - Country:US
Mailing Address - Phone:904-475-2039
Mailing Address - Fax:904-330-0668
Practice Address - Street 1:3720 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3814
Practice Address - Country:US
Practice Address - Phone:904-475-2039
Practice Address - Fax:904-330-0668
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2018-11-08
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Provider Licenses
StateLicense IDTaxonomies
FLME46561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine