Healthcare Provider Details
I. General information
NPI: 1851849343
Provider Name (Legal Business Name): CARLOS MANUEL ZAPATA-REYES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/14/2016
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20911 NW 2ND AVE
MIAMI FL
33169-2105
US
IV. Provider business mailing address
20911 NW 2ND AVE
MIAMI GARDENS FL
33169-2105
US
V. Phone/Fax
- Phone: 786-297-0070
- Fax: 786-265-0974
- Phone: 786-297-0070
- Fax: 786-265-0974
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | S8940 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | ME162522 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: