Individual provider Active NPI

Jessica B Reyes

  • Speech/Language/Hearing Specialist/Technologist
  • Middleburg, FL
National Provider Identifier
1104637701
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X
Practice address
3869 Bronco Rd
Middleburg, FL 32068-8821
Phone
(904) 699-2532
NPI assigned
Jan 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech/Language/Hearing Specialist/Technologist 235500000X FL Primary

Addresses

Primary practice location

3869 Bronco Rd
Middleburg, FL 32068-8821

Mailing address

3869 Bronco Rd
Middleburg, FL 32068-8821
Phone (904) 699-2532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1104637701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3869 BRONCO RD",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688821",
            "telephone_number": "904-699-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3869 BRONCO RD",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688821",
            "telephone_number": "904-699-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JESSICA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.