Provider Demographics
NPI:1790128858
Name:REEVES, COREY JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:JOSEPH
Last Name:REEVES
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:PO BOX 25201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5201
Mailing Address - Country:US
Mailing Address - Phone:813-701-5804
Mailing Address - Fax:813-536-3413
Practice Address - Street 1:3909 GALEN CT STE 104
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6824
Practice Address - Country:US
Practice Address - Phone:813-701-5804
Practice Address - Fax:813-536-3413
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1266132081P2900X
NC2017-00743207LP2900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program