Healthcare Provider Details

I. General information

NPI: 1922236058
Provider Name (Legal Business Name): REY MEDICAL AND PAIN CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8967 TAFT ST
PEMBROKE PINES FL
33024-4648
US

IV. Provider business mailing address

7101 SW 78TH CT
MIAMI FL
33143-2707
US

V. Phone/Fax

Practice location:
  • Phone: 786-251-7928
  • Fax: 954-473-0211
Mailing address:
  • Phone: 786-251-7928
  • Fax: 954-473-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFAEL REY
Title or Position: PRESIDENT
Credential: MD
Phone: 786-251-7928