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General NPI Number Information
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NPI Number | 1841791993
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Entity Type | Individual
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Provider Name | ROSELYNN REYES MS
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Gender | Female
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 2291 NW 170TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2058
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Country | US
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Telephone | 787-934-8724
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 824813
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City | PEMBROKE PINES
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State | FL
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Zip | 33082-4813
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ8502
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License Number State | FL
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