Healthcare Provider Details

I. General information

NPI: 1033037395
Provider Name (Legal Business Name): GABRIEL REYES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 BEACON ST
BROOKLINE MA
02446-5237
US

IV. Provider business mailing address

410 WEXFORD WAY APT 523
SAINT AUGUSTINE FL
32095-0125
US

V. Phone/Fax

Practice location:
  • Phone: 857-307-4680
  • Fax:
Mailing address:
  • Phone: 305-608-5212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40932
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number89685
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: