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General NPI Number Information
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NPI Number | 1386372696
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Entity Type | Organization
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Legal Business Name | SUBOXONE HEALTH CLINIC LLC
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Dates
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Enumeration Date | 08/13/2022
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 2281 LEE RD STE 102
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City | WINTER PARK
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State | FL
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Zip | 32789-7205
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Country | US
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Telephone | 386-848-8751
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Fax | 866-401-0161
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Provider Business Mailing Address
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Address Line | 6320 1/2 EL MIRANDO ST
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City | AUSTIN
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State | TX
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Zip | 78741-2412
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Country | US
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Telephone | 386-214-9990
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ALIAKSANDRA REGAN
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Credential | PA
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Telephone | 386-848-8751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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