Regen Primary Medical Llc | |
8390 Champions Gate Blvd Ste 108 Champions Gate FL 33896-8311 | |
(714) 551-9576 | |
Not Available |
Full Name | Regen Primary Medical Llc |
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Speciality | Clinic/center |
Location | 8390 Champions Gate Blvd Ste 108, Champions Gate, Florida |
Authorized Official Name and Position | Bryn Henderson (OWNER) |
Authorized Official Contact | 7145519576 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Regen Primary Medical Llc 8390 Champions Gate Blvd Ste 108 Champions Gate FL 33896-8311 Ph: () - | Regen Primary Medical Llc 8390 Champions Gate Blvd Ste 108 Champions Gate FL 33896-8311 Ph: (714) 551-9576 |
NPI Number | 1508475682 |
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Provider Enumeration Date | 07/24/2020 |
Last Update Date | 07/24/2020 |
Identifier | Type | State | Issuer |
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1508475682 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |