Healthcare Provider Details

I. General information

NPI: 1972756773
Provider Name (Legal Business Name): RHEINCHARD REYES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4659 W FLAGLER ST
CORAL GABLES FL
33134-1512
US

IV. Provider business mailing address

4659 W FLAGLER ST
CORAL GABLES FL
33134-1512
US

V. Phone/Fax

Practice location:
  • Phone: 305-445-3372
  • Fax: 305-445-3359
Mailing address:
  • Phone: 305-445-3372
  • Fax: 305-445-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME77894
License Number StateFL

VIII. Authorized Official

Name: RHEINCHARD REYES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-445-3372