Provider Demographics
NPI:1780638304
Name:PAYA, REINALDO (MD)
Entity type:Individual
Prefix:DR
First Name:REINALDO
Middle Name:
Last Name:PAYA
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 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-200-5000
Mailing Address - Fax:
Practice Address - Street 1:975 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3412
Practice Address - Country:US
Practice Address - Phone:305-819-6300
Practice Address - Fax:844-870-0091
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066589207R00000X
FLME66589208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375508800Medicaid
FLME0066589OtherMEDICAL LICENSE
FL375508800Medicaid
FLBP3678983OtherDEA