Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | POR66 | FL |
N | 222Z00000X | Podiatrist | POR66 | FL |
Y | 224P00000X | Prosthetist | POR66 | FL |
NPI | 1003922444 |
---|---|
Provider Name | Mr. Eduardo M Reyes |
First Address | Miami, FL 33173-2825 |
Second Address | Miami, FL 33155-3244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 02/02/2010 |