Provider Demographics
NPI:1063276426
Name:REYNOSA, VARONA TRIANA (MA)
Entity type:Individual
Prefix:MS
First Name:VARONA
Middle Name:TRIANA
Last Name:REYNOSA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 NE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-1668
Mailing Address - Country:US
Mailing Address - Phone:239-296-8334
Mailing Address - Fax:
Practice Address - Street 1:1933 NE 15TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-1668
Practice Address - Country:US
Practice Address - Phone:239-296-8334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 3747P1801X, 374U00000X, 376K00000X, 253Z00000X
FL3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide