Healthcare Provider Details

I. General information

NPI: 1760110308
Provider Name (Legal Business Name): RENATA JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2328 HANCOCK BRIDGE PKWY STE 101
CAPE CORAL FL
33990-1455
US

IV. Provider business mailing address

2022 NW 20TH TER
CAPE CORAL FL
33993-2933
US

V. Phone/Fax

Practice location:
  • Phone: 239-246-8751
  • Fax:
Mailing address:
  • Phone: 954-218-4486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: