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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114108552 | NPPES |
| Florida | MEDICAID | 2803381-00 |
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