=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255085452
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REGINA DOLORES PERRY APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2022
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1900 BROTHER GEENEN WAY
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34236-7102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-529-0200
-----------------------------------------------------
Fax | 833-606-0218
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1750 17TH ST STE E
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34234-8666
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-529-0200
-----------------------------------------------------
Fax | 855-526-0216
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | APRN11016556
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------