NPI 1922655885

Reginald Pernell

Practitioner Driver Deltona, FL

Practice location

Address: 1650 Howland Blvd, Deltona, FL 32738-5318
Phone: (352) 364-3475

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence P654-733-64--144-0 (FL)

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Registry record

NPI: 1922655885
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Aug 2019
Record last updated: 23 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.