Provider Demographics
NPI:1992177158
Name:FERRER, REYNALDO (ARNP)
Entity type:Individual
Prefix:MR
First Name:REYNALDO
Middle Name:
Last Name:FERRER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 S ORLANDO AVE
Mailing Address - Street 2:STE C
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4870
Mailing Address - Country:US
Mailing Address - Phone:407-482-9713
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 537N
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-894-4693
Practice Address - Fax:407-896-0569
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9181162282N00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-1561574OtherNEPHROLOGY ASSOCIATES OF CENTRAL FLORIDA EIN