Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | ME-0079216 | FL |
Y | 2086S0120X | Pediatric Surgery | ME130239 | FL |
NPI | 1437176021 |
---|---|
Provider Name | Dr. Cynthia Reyes |
First Address | Clearwater, FL 33759-3012 |
Second Address | Tampa, FL 33607-6307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 22/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019541500 | (05) | FL |
F00891 | (02) |