Healthcare Provider Details

I. General information

NPI: 1932389319
Provider Name (Legal Business Name): REGA MENTAL HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 WILES RD STE 202
CORAL SPRINGS FL
33067-2063
US

IV. Provider business mailing address

7501 WILES RD STE 202
CORAL SPRINGS FL
33067-2063
US

V. Phone/Fax

Practice location:
  • Phone: 954-341-1022
  • Fax: 954-341-1082
Mailing address:
  • Phone: 954-341-1022
  • Fax: 954-341-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. RICARDO K ESPAILLAT
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 954-341-1022