Provider Demographics
NPI:1780483321
Name:REGINA ASIHENE MD LLC
Entity type:Organization
Organization Name:REGINA ASIHENE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASIHENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-451-6871
Mailing Address - Street 1:5856 BOGGS FORD RD
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-5822
Mailing Address - Country:US
Mailing Address - Phone:386-451-6871
Mailing Address - Fax:
Practice Address - Street 1:3130 OPPORTUNITY CT
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-3457
Practice Address - Country:US
Practice Address - Phone:386-451-6871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty