Individual provider Active NPI

Mauricio Correa Reyes

  • Pharmacist
  • Miami, FL
National Provider Identifier
1730069212
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS62997 Issued in FL
Practice address
104 NW 85TH CT
Miami, FL 33126-3815
Phone
(786) 461-4715
NPI assigned
Sep 4, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PS62997 FL Primary

Addresses

Primary practice location

104 NW 85TH CT
Miami, FL 33126-3815

Mailing address

104 NW 85TH CT
Miami, FL 33126-3815

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

State licenses

LicenseStateTypeSpecialty
PS62997FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1730069212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 NW 85TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NW 85TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263815",
            "telephone_number": "786-461-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA REYES",
        "first_name": "MAURICIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS62997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.