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Individual

ABBY REGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1700 SE HILLMOOR DR, PORT ST LUCIE, FL 34952-7539
(772) 398-3623
Mailing address
1800 SE TIFFANY AVE, PORT ST LUCIE, FL 34952-7521

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28489
MS
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/05/2017
Last updated
06/14/2021
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