Basic Information
| Provider Information | |||||||||
| NPI: | 1760461057 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REYES-MOROZ | ||||||||
| FirstName: | CELIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | REYES | ||||||||
| OtherFirstName: | CELIA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1960 NE 47TH ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333087708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544935005 | ||||||||
| FaxNumber: | 9549380957 | ||||||||
| Practice Location | |||||||||
| Address1: | 1960 NE 47TH ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333087708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544935005 | ||||||||
| FaxNumber: | 9549380957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 02/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME33375 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 050063737 | 01 | FL | RAILROAD MEDICARE | OTHER | 204929 | 01 | FL | AVMED | OTHER | 035843600 | 05 | FL | MEDICAID | 93959 | 01 | FL | BCBS OF FLORIDA | OTHER |