Provider Demographics
NPI:1477823904
Name:MORRIS SOLIS, REGINA LUWANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:LUWANDA
Last Name:MORRIS SOLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E MELBOURNE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5970
Mailing Address - Country:US
Mailing Address - Phone:877-377-6547
Mailing Address - Fax:
Practice Address - Street 1:20 E MELBOURNE AVE STE 102
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5970
Practice Address - Country:US
Practice Address - Phone:877-377-6547
Practice Address - Fax:321-872-7433
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115021207LP2900X
NJTRAINING PERMIT207L00000X
SC35899207LP2900X, 208VP0014X
MAFELLOWSHIP208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTMF15OtherBCBS
FL107610800Medicaid
FLOU424OtherHF MEDICARE