Provider Demographics
NPI:1891100764
Name:REYES, ANIA M (AUD)
Entity Type:Individual
Prefix:
First Name:ANIA
Middle Name:M
Last Name:REYES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:TOMASIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1131 N 35TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5403
Practice Address - Country:US
Practice Address - Phone:954-265-1616
Practice Address - Fax:954-893-6325
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237600000X
FLAY 1898231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIV736ZOtherMEDICARE PTAN