Provider Demographics
NPI:1356012264
Name:REGA MENTAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:REGA MENTAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPAILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-346-8300
Mailing Address - Street 1:7501 WILES RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2063
Mailing Address - Country:US
Mailing Address - Phone:954-346-8300
Mailing Address - Fax:954-346-8303
Practice Address - Street 1:2601 W LAKE MARY BLVD STE 113
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3567
Practice Address - Country:US
Practice Address - Phone:407-328-1005
Practice Address - Fax:407-328-1020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGA MENTAL HEALTH CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC8227OtherAHCA LICENSE