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General NPI Number Information
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NPI Number | 1205233558
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Entity Type | Organization
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Legal Business Name | SILVANA GONZALEZ REILEY MD LLC
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 4055 NW 97TH AVE STE 100
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City | DORAL
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State | FL
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Zip | 33178-2911
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Country | US
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Telephone | 786-452-1067
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Fax | 786-472-1280
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Provider Business Mailing Address
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Address Line | 9821 NW 88TH TER
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City | DORAL
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State | FL
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Zip | 33178-2495
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Country | US
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Telephone | 786-899-0391
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Fax | 786-472-1280
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Authorized Official
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Title or Position | MD MANAGER
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Name | SILVANA G GONZALEZ REILEY
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Credential | MD
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Telephone | 786-452-1067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME 105503
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License Number State | FL
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