Provider Demographics
NPI:1720046238
Name:REY, IRMA REGINA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:REGINA
Last Name:REY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 N KENDALL DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2299
Mailing Address - Country:US
Mailing Address - Phone:305-595-4300
Mailing Address - Fax:305-598-4155
Practice Address - Street 1:8720 N KENDALL DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-595-4300
Practice Address - Fax:305-598-4155
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41341174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069330800Medicaid
FLD27988Medicare UPIN
FL96468Medicare ID - Type UnspecifiedMEDICARE