Healthcare Provider Details

I. General information

NPI: 1194920298
Provider Name (Legal Business Name): NELDES REGINA MARRANZINI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REGINA MARRANZINI MD

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13935 WALCOTT AVE
ORLANDO FL
32827-7434
US

IV. Provider business mailing address

13935 WALCOTT AVE
ORLANDO FL
32827-7434
US

V. Phone/Fax

Practice location:
  • Phone: 954-589-6862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME 94781
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME94781
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: