Newly enumerated
The official enumeration date falls within the documented new-enumeration window.
- Enumeration date is 23 days before observation
Type 1 individualNPI 1669399671
AVA REVERENDO
111N00000X · FORT PIERCE, FL
Why this profile is appearing now
Observed change signals
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 111N00000X | 111N00000X | Primary |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s