Healthcare Provider Details

I. General information

NPI: 1255334074
Provider Name (Legal Business Name): RENEWAL MEDICAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 VIA REGINA
BOCA RATON FL
33433-3920
US

IV. Provider business mailing address

6655 VIA REGINA
BOCA RATON FL
33433-3920
US

V. Phone/Fax

Practice location:
  • Phone: 954-914-9199
  • Fax:
Mailing address:
  • Phone: 954-914-9199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME59850
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL JOHN ARUTA
Title or Position: OWNER
Credential: MD
Phone: 954-929-1200