Provider Demographics
NPI:1356732275
Name:REYES CANALS, OSMIL ATILA (DDS)
Entity type:Individual
Prefix:
First Name:OSMIL
Middle Name:ATILA
Last Name:REYES CANALS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 SW 151ST CT UNIT 714
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3125
Mailing Address - Country:US
Mailing Address - Phone:786-295-6363
Mailing Address - Fax:
Practice Address - Street 1:8001 SW 151ST CT
Practice Address - Street 2:UNIT 714
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3125
Practice Address - Country:US
Practice Address - Phone:786-295-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist