| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 07/24/2020 |
| Last Update Date | 07/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508475682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |