Provider Demographics
NPI:1700894243
Name:REIS, RONALD N (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:N
Last Name:REIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5757 MICHELANGELO ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:305-445-1221
Mailing Address - Fax:305-740-3479
Practice Address - Street 1:2601 SW 37TH AVE
Practice Address - Street 2:STE 702
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2700
Practice Address - Country:US
Practice Address - Phone:305-445-1221
Practice Address - Fax:305-648-1088
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME64313208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250309300Medicaid
FL28870OtherMEDICARE PCAN