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General NPI Number Information
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NPI Number | 1275255077
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Entity Type | Individual
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Provider Name | ASIEL REGUEIRO MSN, FNP-C, AGACNP-C
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 1690 DUNLAWTON AVE STE 210
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City | PORT ORANGE
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State | FL
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Zip | 32127-8980
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Country | US
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Telephone | 386-763-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 10260 SW 134TH ST
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City | MIAMI
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State | FL
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Zip | 33176-6143
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11019586
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License Number State | FL
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