Provider Demographics
NPI:1346243359
Name:BATAILLE, REGINE (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:REGINE
Middle Name:
Last Name:BATAILLE
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SE 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-737-1317
Mailing Address - Fax:561-364-0097
Practice Address - Street 1:1260 S FEDERAL HWY
Practice Address - Street 2:STE 202
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6045
Practice Address - Country:US
Practice Address - Phone:561-737-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-03-12
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
FLME0079891208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260349700Medicaid
FL3400139003OtherCIGNA
FL218507OtherAMERIGROUP
FL58050OtherHEALTH OPIONS
FL2535190OtherAETNA
FLSG004782-F356OtherVISTA
FL58050OtherBCBSFL
FL2535190OtherAETNA