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REGEN PRIMARY MEDICAL LLC
NPI 1508475682
Clinic/Center in Champions Gate, FL

Active since July 24, 2020
8390 CHAMPIONS GATE BLVD STE 108, CHAMPIONS GATE, FL 33896(714) 551-9576 Get Directions Write a Review

NPPES record last updated: July 24, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Regen Primary Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REGEN PRIMARY MEDICAL LLC (NPI 1508475682) is a healthcare organization registered as a clinic/center in Champions Gate, Florida and active in the NPI registry since July 2020. The organization lists Bryn Henderson, Owner, as its authorized official.

NPPES Registry Identity

NPI1508475682
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameREGEN PRIMARY MEDICAL LLC
Location Address8390 CHAMPIONS GATE BLVD STE 108Champions Gate, FL 33896-8311
Mailing Address8390 Champions Gate Blvd Ste 108Champions Gate, FL 33896-8311
Phone(714) 551-9576
Organization SubpartNo
Authorized OfficialBryn HendersonOwner · (714) 551-9576
Enumeration DateJuly 24, 2020
NPPES CertifiedJuly 24, 2020
✔ NPI 1508475682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
8390 CHAMPIONS GATE BLVD STE 108, Champions Gate, FL 33896
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEXT GENERATION CHIROPRACTIC & WELLNESS LLC
Chiropractor
8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL 33896
Polk County (407) 885-9229
DR. CHRISTINE MARIE PALES DNP, ARNP, FNP-C
Nurse Practitioner (Family)
8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL 33896
Polk County (407) 683-9205
CORCOBA FAMILY HEALTH CARE
Clinic/Center (Primary Care)
8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL 33896
Polk County (863) 521-4497
FRAINELYS CRUZ MONTANEZ NP
Nurse Practitioner (Psychiatric/Mental Health)
8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL 33896
Polk County (321) 341-4343
ELIZABETH LEON CORCOBA MSN, APRN, FNP-C
Nurse Practitioner (Family)
8390 CHAMPIONS GATE BLVD STE 108
CHAMPIONS GATE, FL 33896
Polk County (863) 521-4497

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Regen Primary Medical LLC's NPI number?

The NPI number for Regen Primary Medical LLC is 1508475682. It was assigned to this organization in the NPPES registry on July 24, 2020.

Where is Regen Primary Medical LLC located?

Regen Primary Medical LLC is located at 8390 Champions Gate Blvd Ste 108, Champions Gate, FL 33896. The listed phone number is (714) 551-9576.

What is Regen Primary Medical LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Regen Primary Medical LLC was last updated on July 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.