Healthcare Provider Details

I. General information

NPI: 1740947357
Provider Name (Legal Business Name): RENAN AMADOR MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N STATE ROAD 7
MARGATE FL
33063-4556
US

IV. Provider business mailing address

PO BOX 442152
MIAMI FL
33144-9152
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RENAN AMADOR
Title or Position: PRESIDENT
Credential: MD
Phone: 786-709-8862