Brian Alexander Reyes, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL6266 Issued in FL

Practice address

100 Servais Way
Hurlburt Field, FL 32544

Phone

(850) 884-4661

NPI assigned

Sep 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1730635376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 BAY PINE CIR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325639423",
            "telephone_number": "954-629-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SERVAIS WAY",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-884-4661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1412 Nomad way",
            "address_purpose": "LOCATION",
            "city": "Eglin Air Force Base",
            "state": "FL",
            "postal_code": "32542",
            "country_code": "US",
            "telephone_number": "850-885-5077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "BRIAN",
        "middle_name": "ALEXANDER",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": "AT001554",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL6266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Rae Ratcliff
• Wilbert B Reeves II, IDMT
• Daniel Reid, IDMT
• Shane Reilly, ATC
• Ashley Reyes, DDS
• Ryan Rene Reyes
• David Bryan Rhodes Sr., MD
• Jeremy Phillip Rhodus, IDMT
• Christina M Rincon-Keith, PHD
• Jason B Robbins, IDMT

• Athletic Trainer in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.