Healthcare Provider Details

I. General information

NPI: 1982568309
Provider Name (Legal Business Name): RENOVO MENTAL HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 MOON LAKE DR
NAPLES FL
34104-6619
US

IV. Provider business mailing address

1055 MOON LAKE DR
NAPLES FL
34104-6619
US

V. Phone/Fax

Practice location:
  • Phone: 786-300-2787
  • Fax:
Mailing address:
  • Phone: 786-300-2787
  • 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: ZORAYA ALVAREZ HERNANDEZ
Title or Position: CEO
Credential: APRN
Phone: 786-300-2787