MARILYN L REGIS (NPI# 1073572863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073572863 |
| Entity Type | Individual |
| Full Name | MARILYN L REGIS |
| Credential | MD |
| Practice Address |
1845 Holsonback Dr Daytona Beach FL 32117-5114 |
| Mailing Address |
Po Box 9190 Daytona Beach FL 32120-9190 |
| Practice Telephone | 3862740790 |
| Practice Fax Number | 3862740800 |
| Mailing Telephone | 3862740790 |
| Mailing Fax Number | 3862740800 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2012-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ME 24512 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 267343600 | 05 |
| Street Address |
1845 HOLSONBACK DR |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831158039 | Florida Department of Health | Public Health or Welfare | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2006-03-17 |
| 1891314308 | Martha Johnson | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2020-04-14 |
| 1164059663 | Kristina Michelle Miranda | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2020-03-25 |
| 1730724287 | Marisha Lasha Dixon | Nurse Practitioner | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2019-11-07 |
| 1003332115 | Danielle Nicole Fritts | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2017-08-21 |
| 1700302478 | Trina Denise Cowan | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2017-08-15 |
| 1154846970 | Christine Hulme | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2017-08-14 |
| 1083166714 | Danielle Lorraine Lindmeyer | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2016-10-28 |
| 1780136630 | Kerry Vierengel | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2016-10-26 |
| 1871045724 | Cristin Shea | Dental Hygienist | 1845 Holsonback Dr, Daytona Beach, FL 32117-5114 | 2016-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538517792 | Julie Rae Weinberg | Pediatrics | 10e Pbfs, 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-0001 | 2016-05-28 |
| 1902079395 | John Assi, Md, Pa | Pediatrics | 1346 Mason Ave, Daytona Beach, FL 32117-5508 | 2008-04-08 |
| 1710043559 | Louis O Orezzoli | Pediatrics | 515 Health Blvd, Daytona Beach, FL 32114-1493 | 2006-12-28 |
| 1316049802 | Adela D Carino Caidic | Pediatrics | 431 South Keech St, Daytona Beach, FL 32114-4623 | 2006-09-04 |
| 1477596641 | Halifax Healthcare Systems Inc | Pediatrics | 431 Keech Street, Daytona Beach, FL 32114 | 2006-06-14 |
| 1972501674 | Asphendiar K Khorsandian | Pediatrics | 337 N Clyde Morris Blvd, Daytona Beach, FL 32114-2732 | 2005-07-07 |
| 1033504600 | Jennifer Carbone | Pediatrics | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2015-04-01 |
| 1750455788 | Richard Hartmann | Pediatrics | 201 N Clyde Morris Blvd Ste 200, Halifax Family Health Center, Daytona Beach, FL 32114-2765 | 2006-11-20 |
| 1144322637 | Andrea Jennifer Thorpe | Pediatrics | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2006-09-04 |
| 1801865654 | Brian Vazquez | Pediatrics | 303 North Clyde Morris Blvd., Halifax Health Medical Center, Daytona Beach, FL 32114-2709 | 2006-03-15 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
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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.