Organization
REIL DIST SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL FUENTES (PRESIDENT)
(305) 780-9999
Entity
Organization
Contact information
Practice address
12032 SW 132ND CT STE 204, MIAMI, FL 33186-6409
(305) 780-9999
Mailing address
12032 SW 132ND CT STE 204, MIAMI, FL 33186-6409
(305) 780-9999
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
FL
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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