Provider Demographics
NPI:1932348695
Name:TORRANCE, REGINA
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:TORRANCE
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 1:2200 INDIAN CREEK BLVD WEST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966
Mailing Address - Country:US
Mailing Address - Phone:772-562-3534
Mailing Address - Fax:772-564-8207
Practice Address - Street 1:2200 INDIAN CREEK BLVD WEST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966
Practice Address - Country:US
Practice Address - Phone:772-562-3534
Practice Address - Fax:772-564-8207
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA9928224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant