Provider Demographics
NPI:1548736218
Name:BAROSY, REGINE (ARNP)
Entity Type:Individual
Prefix:
First Name:REGINE
Middle Name:
Last Name:BAROSY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1412
Mailing Address - Country:US
Mailing Address - Phone:954-256-6815
Mailing Address - Fax:
Practice Address - Street 1:5514 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1412
Practice Address - Country:US
Practice Address - Phone:954-256-6815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3420032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty