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NPI Code Detail

MEDICARE: DREW REYNOLDS

MEDICARE: DREW REYNOLDS
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
1363A00000XPhysician AssistantPAT9111550FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437632478
Entity Type Code : Individual
Provider Name (Legal Business Name) : DREW REYNOLDS
Provider Business Mailing Address
First Line : 5227 DOEHRING LN
Second Line :
City : MULBERRY
State : FL
Zip : 33860-9685
Country : US
Telephone Number : 863-944-5226
Fax Number :
Provider Business Practice Location Address
First Line : 10743 NARCOOSSEE RD STE A18
Second Line :
City : ORLANDO
State : FL
Zip : 32832-6947
Country : US
Telephone Number : 407-277-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2018
Last Update Date : 09/14/2018

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Directions to “ DREW REYNOLDS ” Practice Location

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