Provider Demographics
NPI:1225068323
Name:FELIU, REGINA (MD)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:FELIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13780 SW 26TH ST
Mailing Address - Street 2:STE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6302
Mailing Address - Country:US
Mailing Address - Phone:305-553-4595
Mailing Address - Fax:305-553-4596
Practice Address - Street 1:13780 SW 26TH ST
Practice Address - Street 2:STE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6302
Practice Address - Country:US
Practice Address - Phone:305-553-4595
Practice Address - Fax:305-553-4596
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94699208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107759OtherHUMANA
FL302249OtherAVMED
FLSG080570OtherVISTA
FL302249OtherAVMED
FLI49197Medicare UPIN