Provider Demographics
NPI:1790910305
Name:REY, CARLOS ANDRES
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:ANDRES
Last Name:REY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14250 HUNTERS RUN WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4408
Mailing Address - Country:US
Mailing Address - Phone:410-562-9826
Mailing Address - Fax:410-630-5115
Practice Address - Street 1:12 A HARWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:MD
Practice Address - Zip Code:20776-9771
Practice Address - Country:US
Practice Address - Phone:410-562-9826
Practice Address - Fax:410-630-5115
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No172A00000XOther Service ProvidersDriver