Provider Demographics
NPI:1548973431
Name:REGENERATIVE SPORTS MEDICINE, LLC
Entity type:Organization
Organization Name:REGENERATIVE SPORTS MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-530-8507
Mailing Address - Street 1:10113 SUNSET STRIP
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2619
Mailing Address - Country:US
Mailing Address - Phone:954-530-8507
Mailing Address - Fax:954-652-1538
Practice Address - Street 1:10113 SUNSET STRIP
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2619
Practice Address - Country:US
Practice Address - Phone:954-530-8507
Practice Address - Fax:954-652-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty