Provider Demographics
NPI:1801647235
Name:REYES BRUNO, EDUARDO A (MD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:A
Last Name:REYES BRUNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 CYPRESS KNEE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6292
Mailing Address - Country:US
Mailing Address - Phone:407-562-8437
Mailing Address - Fax:
Practice Address - Street 1:121 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2868
Practice Address - Country:US
Practice Address - Phone:407-562-8437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program