Provider Demographics
NPI:1952343550
Name:REISS KANG JAYANETTI PEREDA GALINANES, MD, PA
Entity type:Organization
Organization Name:REISS KANG JAYANETTI PEREDA GALINANES, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-668-1660
Mailing Address - Street 1:6200 SUNSET DR
Mailing Address - Street 2:SUITE 505
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4805
Mailing Address - Country:US
Mailing Address - Phone:305-668-1660
Mailing Address - Fax:350-668-1650
Practice Address - Street 1:6200 SUNSET DR
Practice Address - Street 2:SUITE 505
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-668-1660
Practice Address - Fax:305-668-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38872OtherBCBS NUMBER
FLK1152Medicare PIN