REGENERATIVE MEDICAL GROUP NPI 1578928867

NPI Information

  • NPI: 1578928867
  • Provider Name: REGENERATIVE MEDICAL GROUP
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1400 SE GOLDTREE DR
    STE 207
    PORT SAINT LUCIE, FL
    ZIP 34952
  • Phone: (772) 777-2836

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NPI Details

REGENERATIVE MEDICAL GROUP is a family medicine in Port Saint Lucie, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. REGENERATIVE MEDICAL GROUP NPI is 1578928867. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1400 SE GOLDTREE DR
STE 207
PORT SAINT LUCIE, FL
ZIP 34952-582
Phone: (772) 777-2836

The provider's authorized official is Bryn J Henderson .
The authorized official title is Ceo and has the following contact phone number (714) 981-8058.

The enumeration date for this NPI number is 12/31/2015 and was last updated on 12/31/2015.

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
1207Q00000XFamily Medicine035817CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1IG494AMEDICARE UPINFLORIDA

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: 11/21/2025

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