Provider Demographics
NPI:1235411984
Name:PECARO, REGINA A (CRNA)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:PECARO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:A
Other - Last Name:SALLOUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 N. HARRISON PARKWAY
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2853
Mailing Address - Country:US
Mailing Address - Phone:800-437-2672
Mailing Address - Fax:954-851-1758
Practice Address - Street 1:1309 N. FLAGLER DRIVE,
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-650-6097
Practice Address - Fax:561-650-6195
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9199212367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered