Provider Demographics
NPI:1700849825
Name:HARDIN, REGINA ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:ALLEN
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:DENISE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8130 66TH ST N STE 11
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2111
Mailing Address - Country:US
Mailing Address - Phone:727-265-1353
Mailing Address - Fax:570-202-9973
Practice Address - Street 1:8130 66TH ST N STE 11
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2111
Practice Address - Country:US
Practice Address - Phone:727-265-1353
Practice Address - Fax:727-265-1353
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045033208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H00006Medicare UPIN