Organization
JOSE LUIS REYES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE LUIS REYES BA (WAIVER SUPPORT COORDINATOR)
(787) 221-2198
Entity
Organization
Contact information
Practice address
77 E PARK ST, CENTER HILL, FL 33514-4629
(787) 221-2198
Mailing address
77 E PARK ST, CENTER HILL, FL 33514-4629
(787) 221-2198
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/20/2015
Last updated
09/20/2015
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