MEDICARE: GABRIELLE REYES

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1518499037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE REYES

Provider Business Mailing Address
First Line	:	5151 ADANSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-1330
Country	:	US
Telephone Number	:	407-875-3700
Fax Number	:	407-659-0411

Provider Business Practice Location Address
First Line	:	5151 ADANSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-1330
Country	:	US
Telephone Number	:	407-875-3700
Fax Number	:	407-659-0411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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Directions to “ GABRIELLE REYES ” Practice Location

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