Provider Demographics
NPI:1043451099
Name:REYES HOME CARE #2
Entity type:Organization
Organization Name:REYES HOME CARE #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REINA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:305-261-8372
Mailing Address - Street 1:1640 SW 83RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1100
Mailing Address - Country:US
Mailing Address - Phone:305-261-8372
Mailing Address - Fax:
Practice Address - Street 1:1640 SW 83RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1100
Practice Address - Country:US
Practice Address - Phone:305-261-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REYES HOME CARE #1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL143036000Medicaid