Provider Demographics
NPI:1639550205
Name:REGUEIRO TORRENS, ALINA M
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:M
Last Name:REGUEIRO TORRENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24252 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5176
Mailing Address - Country:US
Mailing Address - Phone:786-973-7221
Mailing Address - Fax:
Practice Address - Street 1:1806 N FLAMINGO RD STE 280
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1031
Practice Address - Country:US
Practice Address - Phone:786-973-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLCBHCMS101081104100000X
FLCBHCM100426104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110111300Medicaid