Healthcare Provider Details

I. General information

NPI: 1477477651
Provider Name (Legal Business Name): ANTHONY JOSEPH REGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2609 S ORANGE AVE
ORLANDO FL
32806-4528
US

IV. Provider business mailing address

13444 PANAMA BEACH CT
ORLANDO FL
32827-3871
US

V. Phone/Fax

Practice location:
  • Phone: 407-641-2444
  • Fax:
Mailing address:
  • Phone: 440-829-4019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: