Individual
ANTONIO REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N HIATUS RD, SUITE 209, PEMBROKE PINES, FL 33026-5207
(954) 965-9860
(954) 965-9870
Mailing address
2160 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME70206
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033303
NHP
FL
01
—
2227616
AETNA
FL
01
—
237204
AVMED
FL
01
—
24164
MEDICA
FL
05
—
256864100
—
FL
01
—
46607
BLUE CROSS BLUE SHIELD
FL
01
—
5699441
AETNA
FL
01
—
59436
HEALTH SUN
FL
01
—
8837
DIMENSION HEALTH
FL
01
—
F00201863802
UNITED HEALTHCARE
FL
01
—
P01041697
RAILROAD MCR
FL
01
—
P01709685
SIMPLY HEALTHCARE
FL
01
—
P1001893
FREEDOM HEALTH
FL
01
—
P942521
OPTIMUM
FL
01
—
PRV0002461
PREFERRED MEDICAL PLAN
FL
01
—
QMP000003674076
MOLINA
FL
Enumeration date
03/31/2006
Last updated
04/12/2017
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