Provider Demographics
NPI:1689850182
Name:REYES, EDUARDO ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:ANTONIO
Last Name:REYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6450 W 21ST CT STE 204
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3942
Mailing Address - Country:US
Mailing Address - Phone:305-826-4424
Mailing Address - Fax:305-826-4426
Practice Address - Street 1:6450 W 21ST CT STE 204
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-3942
Practice Address - Country:US
Practice Address - Phone:305-826-4424
Practice Address - Fax:305-826-4426
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL100147207R00000X
FLME100147208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist