MEDICARE: DR. JOAQUIN ALBERTO REYES MD

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	208D00000X	General Practice Physician	15130	PR
2	146D00000X	Personal Emergency Response Attendant	15130	PR

General Provider Information

NPI Number	:	1790759595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAQUIN ALBERTO REYES MD

Provider Business Mailing Address
First Line	:	655 CALLE COLLINS
Second Line	:	SUMMIT HILLS
City	:	SAN JUAN
State	:	PR
Zip	:	00920-4341
Country	:	US
Telephone Number	:	939-969-1108
Fax Number	:

Provider Business Practice Location Address
First Line	:	385 AVE DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3718
Country	:	US
Telephone Number	:	787-751-1110
Fax Number	:	787-751-1655

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

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	08/16/2024

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