Provider Demographics
NPI:1578679932
Name:REYES, DORA Q
Entity Type:Individual
Prefix:MRS
First Name:DORA
Middle Name:Q
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8485 SW 40TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3244
Mailing Address - Country:US
Mailing Address - Phone:305-551-3412
Mailing Address - Fax:305-551-1945
Practice Address - Street 1:8485 SW 40TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3244
Practice Address - Country:US
Practice Address - Phone:305-552-8400
Practice Address - Fax:305-552-6398
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORT63222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist