Healthcare Provider Details

I. General information

NPI: 1841906971
Provider Name (Legal Business Name): REGINA M SAGLIBENE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 CLYDE MORRIS BLVD STE 300
ORMOND BEACH FL
32174-8144
US

IV. Provider business mailing address

4310 METRO PKWY STE 205
FORT MYERS FL
33916-9416
US

V. Phone/Fax

Practice location:
  • Phone: 386-262-1627
  • Fax:
Mailing address:
  • Phone: 833-362-7935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11023913
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: