Healthcare Provider Details

I. General information

NPI: 1811106578
Provider Name (Legal Business Name): CARLOS EDUARDO CASAS-REYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S ANDREWS AVE FL 3
FORT LAUDERDALE FL
33316-2509
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-763-6655
  • Fax: 954-763-6799
Mailing address:
  • Phone: 954-765-6655
  • Fax: 954-763-6799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME113039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: