RENEWED HEALTH CENTER LLC NPI 1801365648

NPI Information

NPI: 1801365648
Provider Name: RENEWED HEALTH CENTER, LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 10D2179015

Address:
4175 S CONGRESS AVE STE D
PALM SPRINGS, FL
ZIP 33461
Phone: (561) 331-8633
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RENEWED HEALTH CENTER, LLC is a family nurse practitioner in Palm Springs, FL. RENEWED HEALTH CENTER, LLC NPI is 1801365648. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4175 S CONGRESS AVE STE D
PALM SPRINGS, FL
ZIP 33461-725
Phone: (561) 331-8633
Fax: (561) 600-1494

The provider's authorized official is Lynda Germeil .
The authorized official title is Ao and has the following contact phone number (561) 452-8563.

The CLIA number assigned to this NPI record is 10D2179015 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2018 and was last updated on 1/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001216600	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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