Individual provider Active NPI

Regla Rosario Puig Carrillo, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1407718745
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN684934 Issued in FL
Practice address
6005 Gumwood Dr
Jacksonville, FL 32277-1655
Phone
(786) 989-5331
NPI assigned
Nov 25, 2025
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN684934 FL Primary

Addresses

Primary practice location

6005 Gumwood Dr
Jacksonville, FL 32277-1655

Mailing address

6005 Gumwood Dr
Jacksonville, FL 32277-1655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227001040 FL Practitioner - Nurse Practitioner 0446731343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4796 Hodges Blvd
Suite 101
Jacksonville, FL 32224-2209

6005 Gumwood Dr
Jacksonville, FL 32277-1655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN684934FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Institute of Pain Medicine LLC Multi-Specialty CurrentSince Jan 21, 2026 Accepting new patients
Florida Institute of Pain Medicine LLC Multi-Specialty CurrentSince Jan 21, 2026 Accepting new patients
Florida Psychiatry and Wellness, PLLC CurrentSince Feb 19, 2026 Accepting new patients

Locations

3627 University Blvd S
Ste 605
Jacksonville, FL 32216
Phone (904) 658-0176

4796 Hodges Blvd
Ste 101
Jacksonville, FL 32224
Phone (904) 449-7246

105 Whitehall Dr
Ste 115
St Augustine, FL 32086
Phone (904) 800-7246

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1407718745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 GUMWOOD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 GUMWOOD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771655",
            "telephone_number": "786-989-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUIG CARRILLO",
        "first_name": "REGLA",
        "middle_name": "ROSARIO",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN684934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.