Provider Demographics
NPI:1578234381
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:954-346-8300
Practice Address - Street 1:3219 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5308
Practice Address - Country:US
Practice Address - Phone:305-261-6633
Practice Address - Fax:305-261-6680
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
FLHCC7498OtherAHCA FLORIDA