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Organization

MARY B. REYES PH.D. PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NORALIS FRANCO (OFFICE MANAGER)
(305) 919-8099
Entity
Organization

Contact information

Practice address
724 NW 19TH ST, MIAMI, FL 33136-1202
(305) 325-2300
Mailing address
9265 SW 63RD ST, MIAMI, FL 33173-2305
(786) 596-6577

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PY7474
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PY7474
MEDICARE
Enumeration date
07/23/2015
Last updated
07/23/2015
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