Provider Demographics
NPI:1871635334
Name:REGAR, BRYAN (MPT)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:REGAR
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5590 BEE RIDGE RD
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1513
Mailing Address - Country:US
Mailing Address - Phone:941-377-6700
Mailing Address - Fax:941-377-3929
Practice Address - Street 1:5590 BEE RIDGE RD
Practice Address - Street 2:SUITE A-1
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1513
Practice Address - Country:US
Practice Address - Phone:941-377-6700
Practice Address - Fax:941-377-3929
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT-17813261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy