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General NPI Number Information
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NPI Number | 1235408816
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Entity Type | Individual
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Provider Name | MR. JOSHUA REYES
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Gender | Male
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 3500 SE MARICAMP RD
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City | OCALA
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State | FL
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Zip | 34471-6248
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Country | US
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Telephone | 352-694-4193
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Fax |
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Provider Business Mailing Address
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Address Line | 8801 SE 17TH CT
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City | OCALA
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State | FL
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Zip | 34480-9339
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Country | US
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Telephone | 352-867-7872
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0030963
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License Number State | FL
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