MEDICARE: ALEXANDRA RENNINGER

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	2084P0800X	Psychiatry Physician	ANRP11045399	FL

General Provider Information

NPI Number	:	1477405959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA RENNINGER

Provider Business Mailing Address
First Line	:	3643 BLUEFIELD AVE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32934-8386
Country	:	US
Telephone Number	:	321-693-1309
Fax Number	:

Provider Business Practice Location Address
First Line	:	3643 BLUEFIELD AVE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32934-8386
Country	:	US
Telephone Number	:	321-693-1309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ ALEXANDRA RENNINGER ” Practice Location

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