Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 24140 | WV |
N | 111NI0900X | Internist | 24140 | WV |
Y | 207RG0300X | Geriatric Medicine | ME 120914 | FL |
NPI | 1093912172 |
---|---|
Provider Name | Dr. Bernardo J. Reyes Fernandez |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 31/10/2014 |