Provider Demographics
NPI:1083634372
Name:REYES, RENE A (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:A
Last Name:REYES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3700 WASHINGTON ST
Mailing Address - Street 2:SUITE # 404
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8256
Mailing Address - Country:US
Mailing Address - Phone:954-983-3233
Mailing Address - Fax:954-962-7130
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:SUITE # 404
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8256
Practice Address - Country:US
Practice Address - Phone:954-983-3233
Practice Address - Fax:954-962-7130
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL84793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL84793OtherSTATE LICENSE
FL47839OtherBLUE CROSS BLUE SHIELD
FL47839ZMedicare ID - Type Unspecified
FL84793OtherSTATE LICENSE