Organization · Type 2 NPI
Regenesis LLC
Medical Physician Assistant · Pace, FL
NPI number
1366831554
Active
Practice location
4960 Highway 90 Ste 115
Pace, FL 32571-1413
Fax (850) 807-5059
Mailing address
4960 Hwy 90 Suite 115
Pace, FL 32571
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA9108469 (FL) |
Medical Physician Assistant: Definition to come...
About NPI 1366831554
Regenesis LLC's National Provider Identifier is 1366831554, issued on Jan 12, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Pace, FL. The record was last updated on Jan 12, 2015.