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General NPI Number Information
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NPI Number | 1427671643
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Entity Type | Individual
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Provider Name | REGINA F COOPER
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Gender | Female
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 2627 NE 203RD ST STE 109 SUITE 109
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City | AVENTURA
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State | FL
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Zip | 33180-1945
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Country | US
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Telephone | 954-661-7227
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Fax | 305-682-8994
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Provider Business Mailing Address
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Address Line | 2627 NE 203RD ST STE 109 COOPER MEDICAL MANAGEMENT
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City | AVENTURA
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State | FL
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Zip | 33180-1945
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Country | US
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Telephone | 954-661-7227
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Fax | 305-682-8994
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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 | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | 10D2181154
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 10D2181154
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License Number State | FL
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