Basic Information
| Provider Information | |||||||||
| NPI: | 1932389319 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | REGA MENTAL HEALTH CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7501 WILES RD STE 202 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330672063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543411022 | ||||||||
| FaxNumber: | 9543411082 | ||||||||
| Practice Location | |||||||||
| Address1: | 7501 WILES RD STE 202 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330672063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543411022 | ||||||||
| FaxNumber: | 9543411082 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2007 | ||||||||
| LastUpdateDate: | 09/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | ESPAILLAT | ||||||||
| AuthorizedOfficialFirstName: | RICARDO | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9543411022 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 09/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.