| Regency Endocrinology, Diabetes And Metabolism, Inc. | |
|
752 Stirling Center Pl Suite 1008 Lake Mary FL 32746-4889 | |
| (407) 333-1212 | |
| (407) 333-1213 |
| Full Name | Regency Endocrinology, Diabetes And Metabolism, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 752 Stirling Center Pl, Lake Mary, Florida |
| Authorized Official Name and Position | Maha F Ansara (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 4073331212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regency Endocrinology, Diabetes And Metabolism, Inc. 752 Stirling Center Pl Suite 1008 Lake Mary FL 32746-4889 Ph: (407) 333-1212 | Regency Endocrinology, Diabetes And Metabolism, Inc. 752 Stirling Center Pl Suite 1008 Lake Mary FL 32746-4889 Ph: (407) 333-1212 |
| NPI Number | 1215957741 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 10/10/2013 |
| Medicare PECOS PAC ID | 9931185014 |
|---|---|
| Medicare Enrollment ID | O20040629000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215957741 | NPI | - | NPPES |
| 74739 | Other | FL | BCBS OF FLORIDA GROUP ID# |
| 270616400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 0075530 (Florida) | Primary |
| Provider Name | Maha F Ansara |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295754356 PECOS PAC ID: 9537145610 Enrollment ID: I20040630000710 |
| Provider Name | Richard P Whetzel -schill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154612257 PECOS PAC ID: 6507037595 Enrollment ID: I20110923000204 |
| Provider Name | Mark Mitchell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003833633 PECOS PAC ID: 2264333632 Enrollment ID: I20171121000833 |
| Provider Name | Kerrie Fearon Pounall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598201931 PECOS PAC ID: 4183907835 Enrollment ID: I20200218003177 |
| Provider Name | Adriel Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083276158 PECOS PAC ID: 2365866589 Enrollment ID: I20200721003544 |
| Provider Name | Daniel Gerard Funsch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023471547 PECOS PAC ID: 2365789039 Enrollment ID: I20200806002831 |
| Provider Name | Sachin Parekh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285749952 PECOS PAC ID: 6204832314 Enrollment ID: I20201022001883 |
| Provider Name | Nora Bassam Khoury |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1093205114 PECOS PAC ID: 1759794480 Enrollment ID: I20210119001641 |
| Provider Name | Andrea Morganstein |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1003005422 PECOS PAC ID: 0244639409 Enrollment ID: I20210520002425 |
| Provider Name | Tiffani Dawn Lemen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760651210 PECOS PAC ID: 1355472671 Enrollment ID: I20230321000008 |
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