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NPI Code Detail

MEDICARE: LAWRENCE J. REIS, D.C.,P.A.

MEDICARE: LAWRENCE J. REIS, D.C.,P.A.
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
1302R00000XHealth Maintenance OrganizationCH0001632FL
2305R00000XPreferred Provider OrganizationCH0001632FL

General Provider Information

NPI Number : 1972792133
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWRENCE J. REIS, D.C.,P.A.
Provider Business Mailing Address
First Line : 1621 E VINE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3730
Country : US
Telephone Number : 407-847-2898
Fax Number : 321-442-1099
Provider Business Practice Location Address
First Line : 1621 E VINE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3730
Country : US
Telephone Number : 407-847-2898
Fax Number : 321-442-1099
Authorized Official
Title or Position : OWNER
Name : DR. LAWRENCE J. REIS
Credential : D.C.,P.A.
Telephone Number : 407-847-2898
Provider Enumeration Date : 10/23/2007
Last Update Date : 10/23/2007

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