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NPI Code Detail

MEDICARE: MRS. ISABEL CORDOBA REYES M.D.

MEDICARE: MRS. ISABEL CORDOBA REYES M.D.
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
1208000000XPediatrics PhysicianME056195FL

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 : 1629005624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ISABEL CORDOBA REYES M.D.
Provider Business Mailing Address
First Line : 8601 DUNDEE TER
Second Line :
City : MIAMI LAKES
State : FL
Zip : 33016-1402
Country : US
Telephone Number : 786-466-1718
Fax Number : 305-626-4854
Provider Business Practice Location Address
First Line : 16555 NW 25TH AVE
Second Line :
City : OPA LOCKA
State : FL
Zip : 33054-6583
Country : US
Telephone Number : 786-466-1718
Fax Number : 305-626-4854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 07/08/2007

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