Provider Demographics
NPI:1598220600
Name:REYES, CLAUDIA MERCEDES
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MERCEDES
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 1:11800 SW 18TH ST APT 112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1644
Mailing Address - Country:US
Mailing Address - Phone:305-951-9039
Mailing Address - Fax:
Practice Address - Street 1:11800 SW 18TH ST APT 112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1644
Practice Address - Country:US
Practice Address - Phone:305-951-9039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty