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Individual

MR. DOUGLAS RE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
6001 WEBB RD, EMERGENCY DEPARTMENT, TAMPA, FL 33615-3241
(813) 888-7060
Mailing address
861 SW 78TH AVE, SUITE #100B, PLANTATION, FL 33324-3229
(954) 693-0000
(954) 693-0005

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103254
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
292115400
FL
Enumeration date
06/18/2006
Last updated
05/07/2025
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