MEDICARE: REGINA DOLORES PERRY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	APRN11016556	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255085452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA DOLORES PERRY APRN

Provider Business Mailing Address
First Line	:	1750 17TH ST STE E
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34234-8666
Country	:	US
Telephone Number	:	941-529-0200
Fax Number	:	855-526-0216

Provider Business Practice Location Address
First Line	:	1900 BROTHER GEENEN WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-7102
Country	:	US
Telephone Number	:	941-529-0200
Fax Number	:	833-606-0218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2022
Last Update Date	:	12/10/2025

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