Healthcare Provider Details

I. General information

NPI: 1528999810
Provider Name (Legal Business Name): HUE RENEW INTEGRATIVE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S WESTMONTE DR STE 230
ALTAMONTE SPRINGS FL
32714-4269
US

IV. Provider business mailing address

222 S WESTMONTE DR STE 230
ALTAMONTE SPRINGS FL
32714-4269
US

V. Phone/Fax

Practice location:
  • Phone: 689-263-5844
  • Fax:
Mailing address:
  • Phone: 689-263-5844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TANYA JILKEVORKIAN
Title or Position: OWNER
Credential: APRN
Phone: 689-263-5844