Provider Demographics
NPI:1346035425
Name:REY ROBLES, SUSAN I (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:I
Last Name:REY ROBLES
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 EVANGELINA AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-2627
Mailing Address - Country:US
Mailing Address - Phone:787-639-8938
Mailing Address - Fax:
Practice Address - Street 1:609 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1844
Practice Address - Country:US
Practice Address - Phone:787-639-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily