Provider Demographics
NPI:1831909985
Name:PEREZ REINA, MAYELIN
Entity type:Individual
Prefix:
First Name:MAYELIN
Middle Name:
Last Name:PEREZ REINA
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 1:5537 SHELDON RD STE K
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3167
Mailing Address - Country:US
Mailing Address - Phone:813-885-5817
Mailing Address - Fax:813-886-9421
Practice Address - Street 1:5537 SHELDON RD STE K
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3167
Practice Address - Country:US
Practice Address - Phone:813-885-5817
Practice Address - Fax:813-886-9421
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily