Individual
DR. REENA JIJU KAVILAVEETTIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15267 AMBERLY DR, TAMPA, FL 33647-2155
(813) 972-5414
(813) 972-5413
Mailing address
15267 AMBERLY DR, TAMPA, FL 33647-2155
(813) 972-5414
(813) 972-5413
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
9ME0092765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272929600
—
FL
Enumeration date
05/23/2006
Last updated
06/04/2020
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