Individual provider Active NPI

Ethan Anthony Reulet

  • Nurse Practitioner
  • Summerfield, FL
National Provider Identifier
1215576590
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11038180 Issued in FL
Practice address
17136 SE 109TH Terrace Rd Ste 4
Summerfield, FL 34491-9032
Phone
(352) 320-6154
NPI assigned
Jan 3, 2020
Last updated
Jul 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11038180 FL Primary

Addresses

Primary practice location

17136 SE 109TH Terrace Rd Ste 4
Summerfield, FL 34491-9032

Mailing address

17136 SE 109TH Terrace Rd Ste 4
Summerfield, FL 34491-9032
Phone (352) 320-6154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210310000254 LA Practitioner - Nurse Practitioner 7517373905 Reassigns benefits to 4 organizations
I20250402000032 FL Practitioner - Nurse Practitioner 7517373905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
The Orthopaedic Institute, PAGroup PAC ID 2860385242, 113 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
The Villages, FL 32162-1762
Phone (352) 693-3378

4600 SW 46TH Court
Suite 210 220 and 250
Ocala, FL 34474
Phone (352) 620-1980

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular and Thoracic Surgeons of the South, LLC CurrentSince Oct 22, 2024 Accepting new patients
In and Out Urgent Care Covington, LLC CurrentSince Dec 15, 2023 Accepting new patients
Louisiana Hand to Shoulder Center LLC CurrentSince Jan 5, 2020 Accepting new patients
In and Out Urgent Care of Metairie, LLC CurrentSince Dec 15, 2023 Accepting new patients
The Orthopaedic Institute PA CurrentSince Mar 26, 2025 Accepting new patients
In and Out Urgent Care, LLC CurrentSince Dec 15, 2023 Accepting new patients
The Orthopaedic Institute, PA CurrentSince Mar 26, 2025 Accepting new patients
Vein Clinics of Hawaii LLC PastSince Oct 22, 2024 Accepting new patients

Locations

5400 N Federal Hwy
Ste 102
Ft Lauderdale, FL 33308
Phone (954) 771-8772

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

146 SW Orthopedic Ct
Lake City, FL 32024
Phone (386) 755-9215

4600 SW 46th Ct
Ste 210
Ocala, FL 34474
Phone (352) 291-2016

4600 SW 46th Ct
Ste 220
Ocala, FL 34474
Phone (352) 237-4055

4600 SW 46th Ct
Ste 250
Ocala, FL 34474
Phone (352) 291-2400

17270 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 336-0000

2955 Brownwood Blvd
Ste 403
The Villages, FL 32163
Phone (352) 633-7222

13130 Highway 1085
Covington, LA 70433
Phone (985) 261-0261

601 River Highlands Blvd
Ste 200
Covington, LA 70433
Phone (985) 238-0045

716 W 21st Ave
Covington, LA 70433

4080 Lonesome Rd
Ste A
Mandeville, LA 70448
Phone (985) 892-2950

100 N Labarre Rd
Ste C
Metairie, LA 70001
Phone (504) 827-1717

4224 Houma Blvd
Ste 260
Metairie, LA 70006
Phone (504) 887-5555

6225 S Claiborne Ave
New Orleans, LA 70125
Phone (504) 864-8080

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1215576590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17136 SE 109TH TERRACE RD STE 4",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344919032",
            "telephone_number": "352-320-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17136 SE 109TH TERRACE RD STE 4",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344919032",
            "telephone_number": "352-320-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REULET",
        "first_name": "ETHAN",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-03",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11038180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

Verify at the official NPI Registry.