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NPI Code Detail

MEDICARE: MRS. JOHANNA REYES M.S.P.H.L

MEDICARE: MRS. JOHANNA REYES M.S.P.H.L
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
1235Z00000XSpeech-Language Pathologist002028PR

General Provider Information

NPI Number : 1790022465
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOHANNA REYES M.S.P.H.L
Provider Business Mailing Address
First Line : 1710 CALLE SUNGARI
Second Line : RIO PIEDRAS HTS
City : SAN JUAN
State : PR
Zip : 00926-3254
Country : US
Telephone Number : 787-587-5571
Fax Number :
Provider Business Practice Location Address
First Line : 1710 CALLE SUNGARI
Second Line : RIO PIEDRAS HTS
City : SAN JUAN
State : PR
Zip : 00926-3254
Country : US
Telephone Number : 787-587-5571
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2013
Last Update Date : 01/14/2013

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Directions to “ MRS. JOHANNA REYES M.S.P.H.L” Practice Location

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