Individual
MRS. JESSICA REGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5270 BABCOCK ST NE STE 1, PALM BAY, FL 32905-4616
(321) 241-6800
(321) 241-6890
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9108744
FL
Other
Enumeration date
07/02/2015
Last updated
08/07/2023
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