Provider Demographics
NPI:1366267213
Name:REGINA M CARNEY MD PA
Entity type:Organization
Organization Name:REGINA M CARNEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:754-704-6183
Mailing Address - Street 1:7027 W BROWARD BLVD STE 768
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2208
Mailing Address - Country:US
Mailing Address - Phone:754-704-6183
Mailing Address - Fax:615-235-1139
Practice Address - Street 1:2677 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-3340
Practice Address - Country:US
Practice Address - Phone:954-324-4255
Practice Address - Fax:954-212-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Multi-Specialty