Healthcare Provider Details

I. General information

NPI: 1508329855
Provider Name (Legal Business Name): REINA EYE CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 CORAL WAY
MIAMI FL
33145-2731
US

IV. Provider business mailing address

PO BOX 451453
MIAMI FL
33245-1453
US

V. Phone/Fax

Practice location:
  • Phone: 786-353-2975
  • Fax: 305-203-4950
Mailing address:
  • Phone: 786-309-7579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN LEON ROSEN
Title or Position: PRESIDENT
Credential: MD
Phone: 786-309-7579