Healthcare Provider Details

I. General information

NPI: 1023121407
Provider Name (Legal Business Name): AARON MICHAEL REAMES PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S KANNER HWY STE 200
STUART FL
34994-4801
US

IV. Provider business mailing address

PO BOX 417
STUART FL
34995-0417
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-4978
  • Fax: 772-223-2847
Mailing address:
  • Phone: 772-781-2799
  • Fax: 772-781-2716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601002962
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9110537
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: