MEDICARE: REYES & REYES MD PA

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	207Q00000X	Family Medicine Physician	26292	FL
2	207R00000X	Internal Medicine Physician	84793	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	39731	OTHER	FL	BLUE CROSS

General Provider Information

NPI Number	:	1982620324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REYES & REYES MD PA

Provider Business Mailing Address
First Line	:	3700 WASHINGTON ST
Second Line	:	SUITE # 404
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8256
Country	:	US
Telephone Number	:	954-983-3233
Fax Number	:	954-962-7130

Provider Business Practice Location Address
First Line	:	3700 WASHINGTON ST
Second Line	:	SUITE # 404
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8256
Country	:	US
Telephone Number	:	954-983-3233
Fax Number	:	954-962-7130

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. RENE A REYES
Credential	:	M.D.
Telephone Number	:	954-983-3233

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	02/13/2009

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Directions to “REYES & REYES MD PA ” Practice Location

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