Individual
DR. MICHELLE RENEE REILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NP, PHD
Contact information
Practice address
129 SEAGROVE MAIN STREET, 202, ST. AUGUSTINE, FL 32080
(804) 296-4094
(904) 217-0153
Mailing address
129 SEAGROVE MAIN STREET, UNIT 202, ST. AUGUSTINE, FL 32080
(804) 296-4094
(904) 217-0153
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
R080304
MD
261QA1903X
Ambulatory Surgical Clinic/Center
RN 9303002
FL
Other
Enumeration date
07/16/2010
Last updated
01/07/2011
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