MEDICARE: RENEWAL THERAPY SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	225X00000X	Occupational Therapist
4	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1659103448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEWAL THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	5036 TROUBLE CREEK RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4904
Country	:	US
Telephone Number	:	813-735-4635
Fax Number	:

Provider Business Practice Location Address
First Line	:	5036 TROUBLE CREEK RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4904
Country	:	US
Telephone Number	:	813-735-4635
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KARLA FRANCHESKA MIRANDA MEDINA
Credential	:	MD
Telephone Number	:	787-435-5170

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	05/11/2026

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