Provider Demographics
NPI:1699360990
Name:REYES GONZALEZ, DAILYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAILYN
Middle Name:
Last Name:REYES GONZALEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25360 SW 115TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4723
Mailing Address - Country:US
Mailing Address - Phone:786-718-9743
Mailing Address - Fax:
Practice Address - Street 1:13600 SW 288TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1905
Practice Address - Country:US
Practice Address - Phone:305-910-2972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist