MEDICARE: CIRO R 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	ME89828	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1952441651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIRO R REYES MD

Provider Business Mailing Address
First Line	:	13055 SW 42ND ST STE 201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3410
Country	:	US
Telephone Number	:	786-334-5839
Fax Number	:	786-334-5843

Provider Business Practice Location Address
First Line	:	13055 SW 42ND ST STE 201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3410
Country	:	US
Telephone Number	:	786-334-5839
Fax Number	:	786-334-5843

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	11/30/2022

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Directions to “ CIRO R REYES MD” Practice Location

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