Provider Demographics
NPI:1154931103
Name:RECIO, NAOMI
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:RECIO
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 1:4471 CAPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-7077
Mailing Address - Country:US
Mailing Address - Phone:407-750-0516
Mailing Address - Fax:
Practice Address - Street 1:4471 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-7077
Practice Address - Country:US
Practice Address - Phone:407-750-0516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9536175163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse