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General NPI Number Information
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NPI Number | 1104993005
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Entity Type | Organization
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Legal Business Name | BLAS A REYES MD PA
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8940 N KENDALL DR 1002 E
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City | MIAMI
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State | FL
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Zip | 33176-2178
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Country | US
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Telephone | 305-273-8337
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Fax |
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Provider Business Mailing Address
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Address Line | 8940 N KENDALL DRIVE #1002 E
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City | MIAMI
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State | FL
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Zip | 33176-2178
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Country | US
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Telephone | 305-273-8337
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Fax | 305-273-0144
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Authorized Official
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Title or Position | DIRECTOR DOCTOR
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Name | BLAS A REYES
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Credential | MD
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Telephone | 305-273-8337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State | FL
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