REGEN PRIMARY MEDICAL LLC NPI 1508475682

NPI Information

NPI: 1508475682
Provider Name: REGEN PRIMARY MEDICAL LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL
ZIP 33896
Phone: (714) 551-9576
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REGEN PRIMARY MEDICAL LLC is a clinic center in Champions Gate, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). REGEN PRIMARY MEDICAL LLC NPI is 1508475682. The provider is registered as an organization entity type.

The provider's business location address is:

8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL
ZIP 33896-311
Phone: (714) 551-9576

The provider's authorized official is Bryn Henderson .
The authorized official title is Owner and has the following contact phone number (714) 551-9576.

The enumeration date for this NPI number is 7/24/2020 and was last updated on 7/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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