Healthcare Provider Details

I. General information

NPI: 1134044522
Provider Name (Legal Business Name): REG3N LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 W FLAGLER ST
MIAMI FL
33130-1139
US

IV. Provider business mailing address

965 W FLAGLER ST
MIAMI FL
33130-1139
US

V. Phone/Fax

Practice location:
  • Phone: 305-965-9276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NANCY PELLICER
Title or Position: MANAGER
Credential:
Phone: 305-965-9276