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General NPI Number Information
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NPI Number | 1326653718
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Entity Type | Individual
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Provider Name | REGINA SHERMAN
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Gender | Female
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 10135 GATE PKWY N SUITE 1516
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8267
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Country | US
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Telephone | 352-658-1016
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Fax | 800-396-7959
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Provider Business Mailing Address
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Address Line | 10135 GATE PKWY N APT 1516
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8267
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Country | US
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Telephone | 954-224-8216
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Fax | 800-396-7959
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | FL
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