Provider Demographics
NPI:1326190729
Name:REGAN, MICHAEL BRANDON (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRANDON
Last Name:REGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 TOWN CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-4175
Mailing Address - Country:US
Mailing Address - Phone:941-900-4500
Mailing Address - Fax:941-210-4532
Practice Address - Street 1:9025 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4175
Practice Address - Country:US
Practice Address - Phone:941-900-4500
Practice Address - Fax:941-210-4532
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01350111NN0400X
FLCH11247111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E6530002OtherFEDERAL BCBS
52-1934607OtherTAX ID
MDE6530002OtherCAREFIRST BLUE CHOICE
2107050OtherAETNA
MD53603803OtherCAREFIRST BCBS
320469OtherCOVENTRY
MD53603804OtherBCBS
E6530002OtherFEDERAL BCBS
MD53603804OtherBCBS