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NPI Code Detail

MEDICARE: MR. CARL B REGALIZA CRNP

MEDICARE: MR. CARL B REGALIZA CRNP
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
1363L00000XNurse Practitioner1-151587AL
2363LG0600XGerontology Nurse Practitioner1-151587AL

General Provider Information

NPI Number : 1730720244
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARL B REGALIZA CRNP
Provider Business Mailing Address
First Line : 7751 BELFORT PKWY STE 120
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6921
Country : US
Telephone Number : 904-372-3943
Fax Number : 904-212-1618
Provider Business Practice Location Address
First Line : 6801 AIRPORT BLVD
Second Line : USA HEALTH HOSPITAL
City : MOBILE
State : AL
Zip : 36608-3709
Country : US
Telephone Number : 904-372-3943
Fax Number : 904-212-1618
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2019
Last Update Date : 12/21/2025

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