Individual
MRS. REGINA R. DONALDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2695 NW HATCHES HARBOR RD APT 101, PORT ST LUCIE, FL 34983-4127
(772) 332-3339
(772) 323-0055
Mailing address
800 VIRGINIA AVE STE 598, FORT PIERCE, FL 34982-5892
(772) 332-3339
(772) 323-0142
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
FL
253Z00000X
In Home Supportive Care Agency
Primary
—
FL
261QD1600X
Developmental Disabilities Clinic/Center
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019040200
—
FL
05
—
109053700
—
FL
Enumeration date
10/28/2016
Last updated
03/23/2022
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