Provider Demographics
NPI:1346401171
Name:EDUARDO A. REYES MD PA
Entity Type:Organization
Organization Name:EDUARDO A. REYES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-826-4424
Mailing Address - Street 1:6450 W 21ST CT STE 204
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3942
Mailing Address - Country:US
Mailing Address - Phone:305-826-4424
Mailing Address - Fax:305-826-4426
Practice Address - Street 1:6450 W 21ST CT STE 204
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-3942
Practice Address - Country:US
Practice Address - Phone:305-826-4424
Practice Address - Fax:305-826-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL100147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty