Provider Demographics
NPI:1801273693
Name:GREGORY REED, M.D.
Entity type:Organization
Organization Name:GREGORY REED, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-557-1212
Mailing Address - Street 1:7480 FAIRWAY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6879
Mailing Address - Country:US
Mailing Address - Phone:305-557-1212
Mailing Address - Fax:305-825-3011
Practice Address - Street 1:7480 FAIRWAY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6879
Practice Address - Country:US
Practice Address - Phone:305-557-1212
Practice Address - Fax:305-825-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79126OtherBLUE CROSS LEGACY NUMBER
FL79126OtherBLUE CROSS LEGACY NUMBER