Healthcare Provider Details

I. General information

NPI: 1982855466
Provider Name (Legal Business Name): DR. JORGE REY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NW 79TH AVE
MIAMI FL
33122-1174
US

IV. Provider business mailing address

47 NEW SCOTLAND AVE DEPT OF VASCULAR SURGERY; MC-61
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-1000
  • Fax: 305-243-0790
Mailing address:
  • Phone: 518-262-4880
  • Fax: 518-262-5999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME109208
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: