Provider Demographics
NPI:1124376504
Name:TRAN, REGINA (OD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5217
Mailing Address - Country:US
Mailing Address - Phone:407-894-4553
Mailing Address - Fax:407-228-2260
Practice Address - Street 1:4319 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5217
Practice Address - Country:US
Practice Address - Phone:407-894-4553
Practice Address - Fax:407-228-2260
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist