MEDICARE: RICHARD A REINES, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME0030821	FL

General Provider Information

NPI Number	:	1285937300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD A REINES, M.D., P.A.

Provider Business Mailing Address
First Line	:	4614 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6502
Country	:	US
Telephone Number	:	954-987-7230
Fax Number	:	954-989-0913

Provider Business Practice Location Address
First Line	:	4614 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6502
Country	:	US
Telephone Number	:	954-987-7230
Fax Number	:	954-989-0913

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD ALAN REINES
Credential	:	M.D.
Telephone Number	:	954-987-7230

Provider Enumeration Date	:	12/11/2010
Last Update Date	:	12/11/2010

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