Marisol Reyes, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

Practice address

1606 S Signal Butte Rd
Mesa, AZ 85209-1482

Phone

(480) 358-9737

Fax

(480) 358-9739

NPI assigned

Oct 24, 2023

Sex

Female

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

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1881466761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091482",
            "telephone_number": "480-358-9737",
            "fax_number": "480-358-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091482",
            "telephone_number": "480-358-9737",
            "fax_number": "480-358-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MARISOL",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Recovery Center LLC
• Revive Therapies LLC
• Jenessa Reyes Colocado
• April A Reyes
• Maria Theresa Reyes, MD
• Monica C Reyes, RN
• Risela Reyes, RBT
• Sandra Garza Reyes, D.D.S.
• Selina Reyes
• Yadira Reyna

• Optician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Optician in Arizona

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