Provider Demographics
NPI:1437501038
Name:REYES, BENITO II (RBT)
Entity Type:Individual
Prefix:
First Name:BENITO
Middle Name:
Last Name:REYES
Suffix:II
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 NW 97TH AVE APT 419
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4158
Mailing Address - Country:US
Mailing Address - Phone:786-499-8874
Mailing Address - Fax:
Practice Address - Street 1:12855 SW 132ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7207
Practice Address - Country:US
Practice Address - Phone:786-587-0424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-01301247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other