REGENESIS LLC (NPI# 1366831554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366831554 |
| Entity Type | Organization |
| Organization Name | REGENESIS LLC |
| Practice Address |
4960 Highway 90 Ste 115 Pace FL 32571-1413 |
| Mailing Address |
4960 Hwy 90 Suite 115 Pace FL 32571 |
| Practice Telephone | 8508890711 |
| Practice Fax Number | 8508075059 |
| Mailing Telephone | 8508890711 |
| Mailing Fax Number | 8508075059 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |
| Authorized Official Name | DAVID LEMAY (PRESIDENT) |
| Authorized Official Telephone | 85008890711 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9108469 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730674326 | Regenesis LLC | Clinic/Center | 660 Auburn Folsom Rd Ste 203, Auburn, CA 95603-5646 | 2018-06-26 |
| Street Address |
4960 HIGHWAY 90 STE 115 |
| City | PACE |
| State | FL |
| Zip Code | 32571-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528619103 | Sabrina Hall | Behavior Technician | 3802 Hwy 90, Pace, FL 32571 | 2019-09-24 |
| 1902364094 | Audiology Services Company Usa, LLC | Audiologist-Hearing Aid Fitter | 3754 Us Hightway 90, Suite 390a, Pace, FL 32571 | 2019-03-07 |
| 1598245391 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 5012 Highway 90, Pace, FL 32571 | 2018-08-21 |
| 1922529957 | Overwatch Investments | Home Health | 4503 Woodbine Road, Pace, FL 32571 | 2017-06-29 |
| 1215382619 | Andrea Tuttle | Pediatrics | 5755 Quintette Road, Pace, FL 32571 | 2016-05-04 |
| 1134503477 | Joshua Leblanc | Dentist | 4873 Us-90, Pace, FL 32571 | 2015-07-16 |
| 1326468323 | Ileana Bernal-blair | Obstetrics & Gynecology | 3574 Highway 90, Ste 220, Pace, FL 32571 | 2014-04-17 |
| 1710320064 | Victorian Manor Retirement Center,inc. | Assisted Living Facility | 4685 Chumuckla Highway, Pace, FL 32571 | 2013-04-16 |
| 1639460819 | Wayne Kramer | Massage Therapist | 5717 Hwy 90, Pace, FL 32571 | 2011-04-22 |
| 1386942365 | Jennifer Lyn Newstrom | Behavioral Analyst | 4000 Us-90, B, Pace, FL 32571 | 2011-03-01 |
| Find all providers in zip 32571 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093276735 | Caroline Quinn | Physician Assistant | 3754 Highway 90 Ste 200, Pace, FL 32571-1098 | 2019-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.