MEDICARE: DR. RICHARD ALAN REINES M.D.

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	207Q00000X	Family Medicine Physician	ME30821	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396735239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ALAN REINES M.D.

Provider Business Mailing Address
First Line	:	4614 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6502
Country	:	US
Telephone Number	:	954-987-7230
Fax Number	:	954-989-0913

Provider Business Practice Location Address
First Line	:	4614 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6502
Country	:	US
Telephone Number	:	954-987-7230
Fax Number	:	954-989-0913

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

Provider Enumeration Date	:	10/23/2005
Last Update Date	:	03/26/2019

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