Provider Demographics
NPI:1598736886
Name:ASIHENE, REGINA JOSEPHINE (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:JOSEPHINE
Last Name:ASIHENE
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 1:3130 OPPORTUNITY COURT
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119
Mailing Address - Country:US
Mailing Address - Phone:386-451-6871
Mailing Address - Fax:206-750-9481
Practice Address - Street 1:3130 OPPORTUNITY COURT
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119
Practice Address - Country:US
Practice Address - Phone:386-451-6871
Practice Address - Fax:206-750-9481
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075732207R00000X
FLME75732207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1598736886OtherTRICARE
FL1598736886OtherVHN
FLP00798209OtherRAILROAD MEDICARE
FL05011OtherBCBS
FL255202700Medicaid
FL1598736886OtherVHN
FLF97384Medicare UPIN