Regis, Marilyn L

Regis, Marilyn L is an individual health care provider with primary practice located at 1845 Holsonback Dr , Daytona Beach FL 32117-5114. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Regis, Marilyn L can be contacted via phone (386) 274-0790.

Contact Information

Primary practice address
1845 Holsonback Dr Daytona Beach FL 32117-5114
Phone: (386) 274-0790
Fax: (386) 274-0800
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME 24512 Florida

Profile Details

NPI number 1073572863
LBN Legal business name Regis, Marilyn L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Dec 6th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073572863 NPPES
Florida MEDICAID 267343600

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