Provider Demographics
NPI:1013062835
Name:REY, FRANCISCO JESUS (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JESUS
Last Name:REY
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 1:2370 CORPORATE CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7760
Mailing Address - Country:US
Mailing Address - Phone:702-870-2524
Mailing Address - Fax:702-786-6650
Practice Address - Street 1:5425 PARK ST N STE 7W
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-7042
Practice Address - Country:US
Practice Address - Phone:727-202-8140
Practice Address - Fax:727-202-8252
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253873301Medicaid
FL2538733-00Medicaid
FL253873301Medicaid
FL2538733-00Medicaid
FLE0573DMedicare ID - Type Unspecified