Basic Information
| Provider Information | |||||||||
| NPI: | 1366409856 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REID | ||||||||
| FirstName: | PARLANE | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 863407 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328863407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419172600 | ||||||||
| FaxNumber: | 9419177884 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 S OSPREY AVE | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342392928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419177760 | ||||||||
| FaxNumber: | 9419178782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2006 | ||||||||
| LastUpdateDate: | 09/18/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0805X | ME48621 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 043350100 | 05 | FL | MEDICAID | 68402 | 01 | FL | BCBS | OTHER |