Healthcare Provider Details

I. General information

NPI: 1992909329
Provider Name (Legal Business Name): CARLOS EFRAIN REYES M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CARLOS EFRAIN REYES-PEREZ M.D., M.S.

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 NW 16TH AVE
GAINESVILLE FL
32601-4012
US

IV. Provider business mailing address

2460 OLD MOULTRIE RD STE 1
ST AUGUSTINE FL
32086-4198
US

V. Phone/Fax

Practice location:
  • Phone: 352-727-4641
  • Fax: 352-727-7416
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18287
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18287
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME123955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: