Individual
THERESA AUGUSTA REGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1155 35TH LN, SUITE 100, VERO BEACH, FL 32960-6521
(772) 569-2330
(772) 569-2630
Mailing address
1155 35TH LN, SUITE 100, VERO BEACH, FL 32960-6521
(772) 569-2330
(772) 569-2630
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104895
FL
Other
Enumeration date
03/01/2006
Last updated
12/23/2009
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