Provider Demographics
NPI:1114410107
Name:REYES NEUROLOGY LLC
Entity type:Organization
Organization Name:REYES NEUROLOGY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNYS
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES CANDEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-285-4505
Mailing Address - Street 1:335 E LINTON BLVD # 2032
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5023
Mailing Address - Country:US
Mailing Address - Phone:786-285-4505
Mailing Address - Fax:
Practice Address - Street 1:2525 SW 75TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2800
Practice Address - Country:US
Practice Address - Phone:786-285-4505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME123393OtherMEDICAL LICENSE