Provider Demographics
NPI:1093110561
Name:REGAN, ALIAKSANDRA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:ALIAKSANDRA
Middle Name:
Last Name:REGAN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST STE 308
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6406
Mailing Address - Country:US
Mailing Address - Phone:386-214-9990
Mailing Address - Fax:512-836-8801
Practice Address - Street 1:2281 LEE RD STE 102
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7205
Practice Address - Country:US
Practice Address - Phone:386-848-8751
Practice Address - Fax:866-401-0161
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09723363AM0700X
FLPA9108250363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical