Provider Demographics
NPI:1578516191
Name:CIRO R REYES MD P A
Entity Type:Organization
Organization Name:CIRO R REYES MD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CIRO
Authorized Official - Middle Name:R
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-334-5839
Mailing Address - Street 1:13055 SW 42ND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3410
Mailing Address - Country:US
Mailing Address - Phone:786-334-5839
Mailing Address - Fax:786-334-5843
Practice Address - Street 1:13055 SW 42ND ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3410
Practice Address - Country:US
Practice Address - Phone:786-334-5839
Practice Address - Fax:786-334-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89828208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259630000Medicaid
FL259630000Medicaid
FLU3596ZMedicare ID - Type UnspecifiedCIRO R REYES MD
K6548Medicare ID - Type Unspecified