Healthcare Provider Details

I. General information

NPI: 1194749515
Provider Name (Legal Business Name): JOSE REY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PL STE 503
HIALEAH FL
33012-3158
US

IV. Provider business mailing address

7031 SW 59TH ST
MIAMI FL
33143
US

V. Phone/Fax

Practice location:
  • Phone: 305-787-3267
  • Fax: 786-953-5323
Mailing address:
  • Phone: 305-807-5277
  • Fax: 786-238-7355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME62825
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: