Provider Demographics
NPI:1255373049
Name:REYES, AURELIO (MD)
Entity type:Individual
Prefix:
First Name:AURELIO
Middle Name:
Last Name:REYES
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 1:425 S HUNT CLUB BLVD
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4947
Mailing Address - Country:US
Mailing Address - Phone:407-862-1010
Mailing Address - Fax:407-862-1016
Practice Address - Street 1:425 S HUNT CLUB BLVD
Practice Address - Street 2:SUITE 1001
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4947
Practice Address - Country:US
Practice Address - Phone:407-862-1010
Practice Address - Fax:407-862-1016
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0155462080P0202X
FLME864552080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME317050099Medicaid
ME317050099Medicaid
MM8511Medicare ID - Type Unspecified