Healthcare Provider Details

I. General information

NPI: 1467139402
Provider Name (Legal Business Name): REYES REMEDIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2483 NW 177TH TER
MIAMI GARDENS FL
33056-3653
US

IV. Provider business mailing address

602 SE 46TH LN # 1
CAPE CORAL FL
33904-5554
US

V. Phone/Fax

Practice location:
  • Phone: 305-879-7795
  • Fax:
Mailing address:
  • Phone: 305-879-7795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICA LYNN REYES OLSSON
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DPT
Phone: 305-879-7795