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General NPI Number Information
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NPI Number | 1013363514
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Entity Type | Individual
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Provider Name | LUCIA FERNANDA REYES M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 222 ASHVILLE AVE STE 10
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City | CARY
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State | NC
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Zip | 27518-6130
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Country | US
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Telephone | 919-350-7231
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Fax |
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Provider Business Mailing Address
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Address Line | 222 ASHVILLE AVE STE 10
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City | CARY
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State | NC
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Zip | 27518-6130
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Country | US
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Telephone | 919-235-6575
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 218223
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME140690
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2020-03475
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License Number State | NC
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