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NPI Code Detail

MEDICARE: REGINA M BIELAWSKI M.D.

MEDICARE: REGINA M BIELAWSKI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME53605FL
2207RG0300XGeriatric Medicine (Internal Medicine) PhysicianME53605FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01220904OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316943855
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA M BIELAWSKI M.D.
Provider Business Mailing Address
First Line : PO BOX 3162
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84110-3162
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 1325 SAN MARCO BLVD STE 300
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8567
Country : US
Telephone Number : 904-202-4243
Fax Number : 904-390-7415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 06/03/2025

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