Individual
JON ALVIN REIGO DE DIOS MODESTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1580 SAWGRASS CORPORATE PKWY STE 200, SUNRISE, FL 33323-2869
(954) 228-7521
Mailing address
1580 SAWGRASS CORPORATE PKWY STE 200, SUNRISE, FL 33323-2869
(954) 228-7521
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
884244
TX
163W00000X
Registered Nurse
95118046
CA
163W00000X
Registered Nurse
RN-85497
NM
163W00000X
Registered Nurse
Primary
RN205182
AZ
163W00000X
Registered Nurse
RN2320628
MA
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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