Provider Demographics
NPI:1841487071
Name:REYES, MARIA DE LOS A NGELES (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOS A NGELES
Last Name:REYES
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URBANIZACION SANTA ROSA 22 ST B48 -26
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-6819
Mailing Address - Country:US
Mailing Address - Phone:787-787-4718
Mailing Address - Fax:787-787-4718
Practice Address - Street 1:CALLE 22 B48-26
Practice Address - Street 2:URB SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6819
Practice Address - Country:US
Practice Address - Phone:787-787-4718
Practice Address - Fax:787-787-4718
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR16882208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16882OtherMEDICAL LICENSE