ISAURA REYES DE JESUS
NPI 1730905084
Student in an Organized Health Care Education/Training Program in Fort Walton Beach, FL

Q: What is Isaura Reyes De Jesus's NPI number?

The NPI number for Isaura Reyes De Jesus is 1730905084. It was assigned to this individual provider in the NPPES registry on December 2, 2024.

Q: What is Isaura Reyes De Jesus's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since December 02, 2024PECOS Enrolled

1000 MAR WALT DR, FORT WALTON BEACH, FL 32547(850) 494-6072 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 24, 2026, Dec 2, 2024 (2 updates tracked since 2024).

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About Isaura Reyes De Jesus NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ISAURA REYES DE JESUS (NPI 1730905084) is an individual student in an organized health care education/training program in Fort Walton Beach, Florida and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730905084

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameISAURA REYES DE JESUS

Location Address1000 MAR WALT DRFort Walton Beach, FL 32547-6708

Mailing Address1000 Mar Walt DrFort Walton Beach, FL 32547-6708 · (850) 494-6072

Phone(850) 494-6072

Sole ProprietorNo

Enumeration DateDecember 2, 2024

Last NPPES UpdateMarch 24, 20262 updates tracked since enumeration

NPPES CertifiedMarch 24, 2026

✔ NPI 1730905084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1000 MAR WALT DR, Fort Walton Beach, FL 32547

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Isaura Reyes De Jesus is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEANNA RUTH ANDERSON

Dietitian, Registered