Basic Information
| Provider Information | |||||||||
| NPI: | 1336810282 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COVARRUBIAS | ||||||||
| FirstName: | REINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 414 E SIMONDS RD | ||||||||
| Address2: | |||||||||
| City: | SEAGOVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751592130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694392205 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 PRUDENTIAL DR | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322078202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042022000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2021 | ||||||||
| LastUpdateDate: | 09/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 821242 | TX | Y | Nursing Service Providers | Registered Nurse |
No ID Information.