Individual provider Active NPI

Lina Maria Reyes, M.D.

  • Child & Adolescent Psychiatry Physician
  • Fort Myers, FL
National Provider Identifier
1144412388
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME 113055 Issued in FL
Practice address
12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655
Phone
(239) 343-9180
Fax
(239) 343-9188
NPI assigned
Aug 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME 113055 FL
Geriatric Psychiatry Physician 2084P0805X ME 113055 FL
Child & Adolescent Psychiatry Physician 2084P0804X ME 113055 FL Primary

Addresses

Primary practice location

12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180

Other practice location 1

3800 W Broward Blvd Ste 100
Ft Lauderdale, FL 33312-1018
Phone (954) 587-1008 ext. 1064

Other practice location 2

3400 N 29th Ave
Hollywood, FL 33020-1002
Phone (954) 276-3404

Other practice location 3

1407 M D Ln Ste A
Tallahassee, FL 32308-5349
Phone (850) 877-0635

Other identifiers 1

IdentifierTypeStateIssuer
009555700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lreyes341149@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170614002593 FL Practitioner - Psychiatry 7012221930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

12550 New Brittany Blvd
Suite 100
Fort Myers, FL 33907-3655
Phone (239) 343-9180

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 113055FLMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Sep 4, 2023 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Current Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Sep 4, 2023 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

12550 New Brittany Blvd
Fort Myers, FL 33907
Phone (239) 343-9180

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

12550 New Brittany Blvd
Ste 100
Fort Myers, FL 33907
Phone (239) 343-9180

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lreyes341149@direct.leememorial.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1144412388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 W Broward Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333121018",
            "country_code": "US",
            "telephone_number": "954-587-1008 x1064",
            "fax_number": "954-587-0080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 N 29th Ave",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330201002",
            "country_code": "US",
            "telephone_number": "954-276-3404",
            "fax_number": "954-965-6444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1407 M D Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085349",
            "country_code": "US",
            "telephone_number": "850-877-0635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "LINA",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-12",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 113055",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME 113055",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME 113055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009555700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lreyes341149@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.