Healthcare Provider Details

I. General information

NPI: 1043856883
Provider Name (Legal Business Name): REEDER PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BARRACUDA LN
KEY LARGO FL
33037-3733
US

IV. Provider business mailing address

34 BARRACUDA LANE
KEY LARGO FL
33037
US

V. Phone/Fax

Practice location:
  • Phone: 305-396-7803
  • Fax: 305-396-7904
Mailing address:
  • Phone: 937-602-4953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER A REEDER
Title or Position: SOLE OWNER
Credential: DO
Phone: 305-396-7803