Reynaldo L Descalso MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25032 Issued in FL

Legal business name

REYNALDO L DESCALSO MD PA

Practice address

1221 W Stratford Rd
Avon Park, FL 33825-8091

Phone

(863) 453-7579

Fax

(863) 453-8390

NPI assigned

Sep 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rey Lumucso Descalso, 25032

Title

President

Phone

(863) 453-7579

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1265628994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W STRATFORD RD",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338258091",
            "telephone_number": "863-453-7579",
            "fax_number": "863-453-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W STRATFORD RD",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338258091",
            "telephone_number": "863-453-7579",
            "fax_number": "863-453-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNALDO L DESCALSO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "DESCALSO",
        "authorized_official_first_name": "REY",
        "authorized_official_middle_name": "LUMUCSO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-453-7579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "25032"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "25032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037572100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Avon Park, FL
• Providers in Avon Park, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.