Individual
REGINA D DEIPARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NLMT
Contact information
Practice address
533 N NOVA RD, SUITE 102, ORMOND BEACH, FL 32174-4447
(386) 615-4990
(386) 615-4951
Mailing address
102 PINE TREE DR, ORMOND BEACH, FL 32174-2634
(386) 547-3910
(386) 615-4951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
45105
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45105
FLORIDA LICENSE
FL
Enumeration date
09/07/2007
Last updated
09/07/2007
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