Provider Demographics
NPI:1558060129
Name:REYES, SIMONE S (APRN)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:S
Last Name:REYES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:SIMONE
Other - Middle Name:
Other - Last Name:SITCHERAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 746652
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6652
Mailing Address - Country:US
Mailing Address - Phone:904-720-0599
Mailing Address - Fax:904-376-4036
Practice Address - Street 1:836 PRUDENTIAL DR STE 1700
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8344
Practice Address - Country:US
Practice Address - Phone:904-398-0125
Practice Address - Fax:904-376-3206
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023820363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily