Provider Demographics
NPI:1104892975
Name:REGO, SADY M (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SADY
Middle Name:M
Last Name:REGO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:15051 S TAMIAMI TRL STE 203
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5182
Mailing Address - Country:US
Mailing Address - Phone:239-437-8810
Mailing Address - Fax:239-313-2555
Practice Address - Street 1:2366 SURFSIDE BLVD # C-111
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3180
Practice Address - Country:US
Practice Address - Phone:239-360-2795
Practice Address - Fax:239-360-2796
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2018-04-20
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101759363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant