Jorge Reynolds, Lydia M

Jorge Reynolds, Lydia M is an individual health care provider with primary practice located at 1611 Nw 12Th Ave Box 016960, Miami FL 33136-1005. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Jorge Reynolds, Lydia M can be contacted via phone (305) 585-8256.

Contact Information

Primary practice address
1611 Nw 12Th Ave Box 016960 Miami FL 33136-1005
Phone: (305) 585-8256
Fax: (305) 243-8470
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME96171 Florida
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X ME96171 Florida

Profile Details

NPI number 1114108552
LBN Legal business name Jorge Reynolds, Lydia M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2007
Last updated Aug 13th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114108552 NPPES
Florida MEDICAID 2803381-00

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