Individual
MARILYN L REGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1845 HOLSONBACK DR, DAYTONA BEACH, FL 32117-5114
(386) 274-0790
(386) 274-0800
Mailing address
PO BOX 9190, DAYTONA BEACH, FL 32120-9190
(386) 274-0790
(386) 274-0800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 24512
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267343600
—
FL
Enumeration date
03/21/2006
Last updated
12/06/2012
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