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General NPI Number Information
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NPI Number | 1710079728
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Entity Type | Organization
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Legal Business Name | HIALEAH FAMILY FOOT CARE CENTER INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 1301 W 68TH ST STE A
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City | HIALEAH
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State | FL
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Zip | 33014-4579
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Country | US
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Telephone | 305-557-2001
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Fax | 305-557-2742
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Provider Business Mailing Address
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Address Line | 1301 W 68TH ST STE A
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City | HIALEAH
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State | FL
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Zip | 33014-4579
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Country | US
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Telephone | 305-557-2001
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Fax | 305-557-2742
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICARDO REYES
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Credential | D.P.M.
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Telephone | 305-557-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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