Robert William Reynolds, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 19695 Issued in FL

Practice address

451 S Amelia Ave
Deland, FL 32724-5917

Phone

(407) 506-2483

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902023948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 STARGAZER TER",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327719202",
            "telephone_number": "407-506-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 S AMELIA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327245917",
            "telephone_number": "407-506-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 19695",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA2263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Restore Therapy Services of Florida LLC
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• Misty M Reyes
• Xiara Reyes
• Shahab Rezvani, MD
• Shawn Marie Rhodes, PHARM.D
• Diana O. Rhys, ARNP
• David Riascos, MD
• Ricardo J. Larrain M.D., P.a.

• Physical Therapy Assistant in Deland, FL
• Providers in Deland, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.