Healthcare Provider Details

I. General information

NPI: 1699289132
Provider Name (Legal Business Name): URENU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 11/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 WINCHESTER BLVD
KISSIMMEE FL
34743-3627
US

IV. Provider business mailing address

2412 WINCHESTER BLVD
KISSIMMEE FL
34743
US

V. Phone/Fax

Practice location:
  • Phone: 321-348-7368
  • Fax: 888-974-1047
Mailing address:
  • Phone: 321-348-7368
  • Fax: 888-974-1047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: MRS. KALEENA FRANCOIS HENRY
Title or Position: MANAGING MEMBER
Credential:
Phone: 407-394-8077