Provider Demographics
NPI:1811106578
Name:CASAS-REYES, CARLOS EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:EDUARDO
Last Name:CASAS-REYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-958-5190
Mailing Address - Fax:954-958-5191
Practice Address - Street 1:5353 N FEDERAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3236
Practice Address - Country:US
Practice Address - Phone:954-958-5190
Practice Address - Fax:954-958-5191
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088062207T00000X
MS27587207T00000X
CAA114737207T00000X
FLME113039207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery