Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
IVAN REGALADO RODRIGUEZ
Active Sole ProprietorIVAN REGALADO RODRIGUEZ is a Family Nurse Practitioner healthcare provider located in FORTSON, Georgia. NPI 1639871866 is currently active in the NPPES registry. Verify at CMS.
Family Nurse Practitioner · FORTSON, GA
Registration Details
- NPI Number
- 1639871866
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 21, 2023 (3.3953859308193 yrs)
- Last Updated
- Oct 12, 2025
- Licenses
-
APRN11025390 (FL)RN291972 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4614 WISTERIA LNFORTSON, GA, 318086986Browse GA providers · Browse ZIP 31808
- Phone
- 7708821728
- Primary Specialty
-
Family Nurse Practitioner
363LF0000X
- Additional Specialty
- Family Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.