MEDICARE: DR. RAUL A. REYES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	5904	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0097843	OTHER	PR	PTAN

General Provider Information

NPI Number	:	1215923834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAUL A. REYES

Provider Business Mailing Address
First Line	:	18-4 CALLE 5
Second Line	:	MANSIONES DE TORRIMAR
City	:	GUAYNABO
State	:	PR
Zip	:	00969-3312
Country	:	US
Telephone Number	:	787-720-5123
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 CALLE NIZA
Second Line	:	VILLA CAPRI
City	:	SAN JUAN
State	:	PR
Zip	:	00924-4054
Country	:	US
Telephone Number	:	787-760-2580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	06/25/2013

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Directions to “ DR. RAUL A. REYES ” Practice Location

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