MEDICARE: DR. LOUIS JOSEPH REGISTRE 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
1	207Q00000X	Family Medicine Physician	ME68799	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080088639	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1720056237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS JOSEPH REGISTRE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 44008
Second Line	:	UFJP PROVIDER ENROLLMENT
City	:	JACKSONVILLE
State	:	FL
Zip	:	32231-4008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1697 KINGS RD
Second Line	:	UFJP COLLEGE PARK FAMILY PRACTICE CENTER
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6169
Country	:	US
Telephone Number	:	904-633-0500
Fax Number	:	904-633-0551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	04/22/2009

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Directions to “ DR. LOUIS JOSEPH REGISTRE M.D.” Practice Location

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