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

Provider Other Name: CARLOS MANUEL ZAPATA REYES MD

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6208 PEMBROKE RD
MIRAMAR FL
33023-2216
US

IV. Provider business mailing address

6208 PEMBROKE RD
MIRAMAR FL
33023-2216
US

V. Phone/Fax

Practice location:
  • Phone: 954-961-7100
  • Fax: 954-342-1990
Mailing address:
  • Phone: 954-961-7100
  • Fax: 954-342-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME162522
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberS8940
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: