Provider Demographics
NPI:1083101307
Name:REYES, THAIRY (DO)
Entity Type:Individual
Prefix:DR
First Name:THAIRY
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:THAIRY
Other - Middle Name:GABRIELA
Other - Last Name:REYES VALERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2001 W 68TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1898
Mailing Address - Country:US
Mailing Address - Phone:305-364-2107
Mailing Address - Fax:
Practice Address - Street 1:2001 W. 68TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-364-2107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA329397207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine