MEDICARE: RENOVA BY DESIGN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1457245896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENOVA BY DESIGN, LLC

Provider Business Mailing Address
First Line	:	435 E STATE ROAD 434 STE 500
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5203
Country	:	US
Telephone Number	:	833-317-4665
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 W BROADWAY ST STE A
Second Line	:
City	:	FORT MEADE
State	:	FL
Zip	:	33841-3300
Country	:	US
Telephone Number	:	407-921-9810
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	MRS. CHUYNA HUNTER
Credential	:
Telephone Number	:	833-317-4665

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	12/04/2025

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Directions to “RENOVA BY DESIGN, LLC ” Practice Location

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