Healthcare Provider Details

I. General information

NPI: 1184167926
Provider Name (Legal Business Name): REGIONS ALL CARE HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 VINELAND RD STE 103
ORLANDO FL
32819-7829
US

IV. Provider business mailing address

6001 VINELAND RD STE 103
ORLANDO FL
32819-7829
US

V. Phone/Fax

Practice location:
  • Phone: 407-704-8131
  • Fax: 888-845-9863
Mailing address:
  • Phone: 407-704-8131
  • Fax: 888-845-9863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberME20548
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberME20548
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberME20548
License Number StateFL

VIII. Authorized Official

Name: DR. HERACLIO F. CASTRO JR.
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 407-704-8131