Provider Demographics
NPI:1831673060
Name:REYES LEBRON, ZOYARA (DC)
Entity Type:Individual
Prefix:DR
First Name:ZOYARA
Middle Name:
Last Name:REYES LEBRON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 ASTON GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-3004
Mailing Address - Country:US
Mailing Address - Phone:787-692-4259
Mailing Address - Fax:
Practice Address - Street 1:401 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5750
Practice Address - Country:US
Practice Address - Phone:787-692-4259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor