Provider Demographics
NPI:1609993187
Name:REYES, RITA R (OTR)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:R
Last Name:REYES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MARIA RITA
Other - Middle Name:R
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:4745 SW 13TH CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6152 VERDE TRL N
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2430
Practice Address - Country:US
Practice Address - Phone:561-852-4173
Practice Address - Fax:561-852-4956
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT5580225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist