MEDICARE: MISS REGINA PADGETT

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	1041C0700X	Clinical Social Worker	20250	FL
2	171M00000X	Case Manager/Care Coordinator
3	251B00000X	Case Management Agency		FL
4	1041C0700X	Clinical Social Worker	SW20250	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902179948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS REGINA PADGETT

Provider Business Mailing Address
First Line	:	PO BOX 608503
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32860-8503
Country	:	US
Telephone Number	:	407-547-2711
Fax Number	:	407-289-8801

Provider Business Practice Location Address
First Line	:	6249 EDGEWATER DR.
Second Line	:	V1, STE. 7
City	:	ORLANDO
State	:	FL
Zip	:	32810-4739
Country	:	US
Telephone Number	:	407-547-2711
Fax Number	:

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

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	01/27/2023

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Directions to “ MISS REGINA PADGETT ” Practice Location

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