# MAGNOLIA GYNECOLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Magnolia Gynecology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063024149
- **Authorized official:** ALEXANDRIA R. REYES DO (PHYSICIAN OWNER)
- **Authorized official phone:** (813) 773-6627

## Contact information

- **Practice address:** 3216 W AZEELE ST STE 2, TAMPA, FL 33609-3018
- **Practice address phone:** (813) 773-6627
- **Practice address fax:** (813) 443-6001
- **Mailing address:** 3216 W AZEELE ST STE 2, TAMPA, FL 33609-3151
- **Mailing address phone:** (813) 773-6627
- **Mailing address fax:** (813) 443-6001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2020
- **Last updated:** 09/05/2024