Provider Demographics
NPI:1457327637
Name:REYES, ROZITA Z (PA)
Entity Type:Individual
Prefix:MS
First Name:ROZITA
Middle Name:Z
Last Name:REYES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:ROZITA
Other - Middle Name:
Other - Last Name:ZAMANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7001 FOREST AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1726
Mailing Address - Country:US
Mailing Address - Phone:804-282-0831
Mailing Address - Fax:804-288-7135
Practice Address - Street 1:7001 FOREST AVE STE 400
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1726
Practice Address - Country:US
Practice Address - Phone:804-282-0831
Practice Address - Fax:804-288-7135
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
003347A34Medicare ID - Type Unspecified
Q08694Medicare UPIN