Individual
AUSTIN REGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
301 N ALEXANDER ST, PLANT CITY, FL 33563-4303
(813) 757-1290
Mailing address
1425 FOXFIRE DR, APOPKA, FL 32712-3010
(407) 889-2930
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS0003411
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029430600
—
FL
01
—
81899
BCBS
FL
01
—
P00204932
RR MCR
—
Enumeration date
03/07/2006
Last updated
05/14/2008
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