Provider Demographics
NPI:1407195514
Name:EDUARDO REYES D.P.M, P.A.
Entity Type:Organization
Organization Name:EDUARDO REYES D.P.M, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:MARINO
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-551-3412
Mailing Address - Street 1:8485 SW 40 STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1000
Mailing Address - Country:US
Mailing Address - Phone:305-551-3412
Mailing Address - Fax:305-551-1945
Practice Address - Street 1:8485 SW 40 STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1000
Practice Address - Country:US
Practice Address - Phone:305-551-3412
Practice Address - Fax:305-551-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3590213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty