Provider Demographics
NPI:1487387338
Name:REYES GUERRA, ANABEL (MD)
Entity type:Individual
Prefix:
First Name:ANABEL
Middle Name:
Last Name:REYES GUERRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:321-343-6833
Mailing Address - Fax:689-304-0303
Practice Address - Street 1:6336 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-7812
Practice Address - Country:US
Practice Address - Phone:407-259-2383
Practice Address - Fax:407-630-6884
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23450208D00000X
390200000X
FLACN1575208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL120452500Medicaid