Provider Demographics
NPI:1609551886
Name:REYES, LUCIA (APRN11026859)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:APRN11026859
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 SW 149TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4357
Mailing Address - Country:US
Mailing Address - Phone:305-213-9007
Mailing Address - Fax:
Practice Address - Street 1:4240 SW 149TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4357
Practice Address - Country:US
Practice Address - Phone:305-213-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026859207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine