Healthcare Provider Details

I. General information

NPI: 1619293651
Provider Name (Legal Business Name): JOSE R REY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2010
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
33143-1831
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: DR. JOSE R REY
Title or Position: PRESIDENT
Credential: MD
Phone: 305-807-5277