Individual
REGINALD DEAN LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1610 NE MIAMI GARDENS DR, MIAMI, FL 33179-4900
(305) 940-6061
(305) 940-6167
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(305) 940-6016
(305) 940-6167
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9110529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021847500
—
FL
Enumeration date
08/26/2005
Last updated
05/27/2020
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