Provider Demographics
NPI:1427780683
Name:REYES, CRISNEL MORELIA
Entity type:Individual
Prefix:
First Name:CRISNEL
Middle Name:MORELIA
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10830 NW 52ND ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3962
Mailing Address - Country:US
Mailing Address - Phone:786-285-8781
Mailing Address - Fax:
Practice Address - Street 1:5735 MEEKER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1186
Practice Address - Country:US
Practice Address - Phone:937-548-9680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program