Individual
DR. LEOVIGILDO J REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4401 N ANDREWS AVE, OAKLAND PARK, FL 33309-3917
(954) 900-4686
(954) 900-2655
Mailing address
4401 N ANDREWS AVE, OAKLAND PARK, FL 33309-3917
(954) 900-4686
(954) 900-2655
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
038929
GA
208D00000X
General Practice Physician
ME85999
FL
208VP0000X
Pain Medicine Physician
ME85999
FL
208VP0014X
Interventional Pain Medicine Physician
038929
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
ME85999
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038929
AMERIGROUP
GA
05
—
038929
—
GA
01
—
ME85999
AETNA
FL
05
—
ME85999
—
FL
Enumeration date
09/02/2005
Last updated
03/15/2024
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