Individual
REGINE JOLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MPH, CHES, CCM,
Contact information
Practice address
8895 SW 136TH ST, MIAMI, FL 33176-5816
(305) 256-5480
Mailing address
17521 SW 93RD PL, PALMETTO BAY, FL 33157-5768
(305) 256-5480
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN2005292
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01
MEDICARE
FL
Enumeration date
12/20/2018
Last updated
12/20/2018
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