Basic Information
| Provider Information | |||||||||
| NPI: | 1003298779 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REYES ARNALDY | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1749 DAVID WALKER DR | ||||||||
| Address2: | |||||||||
| City: | TAVARES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327785745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523430181 | ||||||||
| FaxNumber: | 3523430812 | ||||||||
| Practice Location | |||||||||
| Address1: | 1749 DAVID WALKER DR | ||||||||
| Address2: | |||||||||
| City: | TAVARES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327785745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523430181 | ||||||||
| FaxNumber: | 3523430812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2015 | ||||||||
| LastUpdateDate: | 08/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME145367 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 293514 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | ME145367 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.