Individual provider Active NPI

Lillian Reguero, M.D.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1992795942
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0043680 Issued in FL
Practice address
3431 S. Orange Ave
Suite B
Orlando, FL 32806-8508
Phone
(407) 422-8873
Fax
(407) 425-4294
NPI assigned
Oct 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X ME0043680 FL
Pediatrics Physician 208000000X ME0043680 FL Primary

Addresses

Primary practice location

3431 S. Orange Ave
Suite B
Orlando, FL 32806-8508

Mailing address

3431 S. Orange Ave
Suite B
Orlando, FL 32806-8508
Phone (407) 422-8873

Other practice location 1

94 W Underwood St
Orlando, FL 32806-1100
Phone (407) 422-8873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0043680FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perinatal Center, PA CurrentSince Dec 16, 2015 Accepting new patients
The Vancouver Clinic Inc PS Past Accepting new patients

Locations

3431 S Orange Ave
Ste B
Orlando, FL 32806
Phone (407) 422-8873

94 Underwood St
Orlando, FL 32806
Phone (407) 422-8873

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1992795942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 S. ORANGE AVE",
            "address_2": "SUITE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068508",
            "telephone_number": "407-422-8873",
            "fax_number": "407-425-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 S. ORANGE AVE",
            "address_2": "SUITE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068508",
            "telephone_number": "407-422-8873",
            "fax_number": "407-425-4294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 W Underwood St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061100",
            "country_code": "US",
            "telephone_number": "407-422-8873",
            "fax_number": "407-425-4294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGUERO",
        "first_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME0043680",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0043680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.