Healthcare Provider Details

I. General information

NPI: 1750292009
Provider Name (Legal Business Name): GERALD E REYES LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2995 N DIXIE HWY
OAKLAND PARK FL
33334-2640
US

IV. Provider business mailing address

17600 NW 5TH AVE APT 516
MIAMI GARDENS FL
33169-4812
US

V. Phone/Fax

Practice location:
  • Phone: 954-357-5775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28144
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: