Individual provider Active NPI

Maribelle De la Torre Reyes, PH.D

  • Clinical Psychologist
  • Tallahassee, FL
National Provider Identifier
1942237730
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY10380 Issued in FL
Practice address
1201 Hays St
Tallahassee, FL 32301-2699
Phone
(301) 525-1113
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY10380 FL Primary

Addresses

Primary practice location

1201 Hays St
Tallahassee, FL 32301-2699

Mailing address

3108 Sunwatch Dr
Wesley Chapel, FL 33544-7720
Phone (301) 525-1113

Other names 1

  • Dr. Maribelle De la Torre Reyes Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190207001983 FL Practitioner - Clinical Psychologist 7911911276 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Nov 15, 2023 Accepting new patients
Mindpath Health Florida, PLLC Clinical CurrentSince Jul 13, 2022 Accepting new patients
Inspira Psychiatric Services PSC Past Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

1725 N University Dr
Ste 350
Coral Springs, FL 33071
Phone (954) 227-2700

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1942237730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 SUNWATCH DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335447720",
            "telephone_number": "301-525-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HAYS ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323012699",
            "telephone_number": "301-525-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA TORRE REYES",
        "first_name": "MARIBELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIBELLE",
            "last_name": "DE LA TORRE REYES",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.