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NPI Code Detail

MEDICARE: FLORITA REYES PA

MEDICARE: FLORITA REYES PA
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
1207Q00000XFamily Medicine PhysicianPA16943CA
2363A00000XPhysician AssistantPA16943CA

General Provider Information

NPI Number : 1326068214
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLORITA REYES PA
Provider Business Mailing Address
First Line : PO BOX 255228
Second Line :
City : SACRAMENTO
State : CA
Zip : 95865-5228
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 3100 DOUGLAS BLVD
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3866
Country : US
Telephone Number : 916-774-8300
Fax Number : 916-773-7145
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 06/10/2016

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Directions to “ FLORITA REYES PA” Practice Location

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