Provider Demographics
NPI:1407878762
Name:REYES, RHEINCHARD ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RHEINCHARD
Middle Name:ROBERTO
Last Name:REYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4659 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1512
Mailing Address - Country:US
Mailing Address - Phone:305-445-3372
Mailing Address - Fax:305-445-3359
Practice Address - Street 1:4659 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1512
Practice Address - Country:US
Practice Address - Phone:305-445-3372
Practice Address - Fax:305-445-3359
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00777894207Q00000X
FLME0077894207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257391100Medicaid
E4254Medicare PIN
FL257391100Medicaid