Provider Demographics
NPI:1003193871
Name:REGAN, ABIGAIL DUNN (DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:DUNN
Last Name:REGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:HILARY
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3536 PENINSULA CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1111
Mailing Address - Country:US
Mailing Address - Phone:321-345-1175
Mailing Address - Fax:
Practice Address - Street 1:3536 PENINSULA CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-1111
Practice Address - Country:US
Practice Address - Phone:321-342-1175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25026225100000X
FLPT-25026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist