Provider Demographics
NPI:1245426386
Name:REGINA P QUINAIN, MD PA
Entity Type:Organization
Organization Name:REGINA P QUINAIN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:P
Authorized Official - Last Name:QUINAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-672-1002
Mailing Address - Street 1:PO BOX 780584
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32878-0584
Mailing Address - Country:US
Mailing Address - Phone:407-672-1002
Mailing Address - Fax:407-673-1003
Practice Address - Street 1:10967 LAKEUNDERHILL ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4434
Practice Address - Country:US
Practice Address - Phone:407-672-1002
Practice Address - Fax:407-823-9206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG82172Medicare UPIN
FLK7307Medicare PIN