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General NPI Number Information
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NPI Number | 1386632990
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Entity Type | Individual
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Provider Name | PATRICK T. REYNOLDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 12235 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4119
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Country | US
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Telephone | 954-265-4325
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Fax | 954-450-4422
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Provider Business Mailing Address
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Address Line | 12335 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026
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Country | US
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Telephone | 954-265-4325
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Fax | 954-276-0744
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME56509
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | ME56509
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | ME56509
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License Number State | FL
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