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General NPI Number Information
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NPI Number | 1366458978
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Entity Type | Organization
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Legal Business Name | REGENETICS HEALTH INSTITUTE, PA
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 988 E OSCEOLA PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34744-1615
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Country | US
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Telephone | 407-483-4079
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Fax | 407-572-8642
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Provider Business Mailing Address
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Address Line | 8815 CONROY WINDERMERE RD #203
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City | ORLANDO
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State | FL
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Zip | 32835-3129
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Country | US
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Telephone | 407-483-4079
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Fax | 407-572-8642
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CARLOS JOSE PLACER
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Credential | MD
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Telephone | 407-933-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME82389
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME82389
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME82389
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License Number State | FL
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