Provider Demographics
NPI:1407397540
Name:RE3 STEM CELL AND HEALING INSTITUTE PLLC
Entity Type:Organization
Organization Name:RE3 STEM CELL AND HEALING INSTITUTE PLLC
Other - Org Name:RE3 INNOVATIVE NEUROSCIENCE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-893-2688
Mailing Address - Street 1:4012 SAWYER RD STE 101-104
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1231
Mailing Address - Country:US
Mailing Address - Phone:941-893-2688
Mailing Address - Fax:941-893-2690
Practice Address - Street 1:4012 SAWYER RD
Practice Address - Street 2:SUITE 101-104
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1231
Practice Address - Country:US
Practice Address - Phone:217-552-3425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical CareGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty