Healthcare Provider Details

I. General information

NPI: 1649280793
Provider Name (Legal Business Name): LOUIS CLARENCE REMYNSE III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 PARK CENTER DR STE 130
ORLANDO FL
32835-7611
US

IV. Provider business mailing address

2101 PARK CENTER DR STE 130
ORLANDO FL
32835-7611
US

V. Phone/Fax

Practice location:
  • Phone: 407-298-6950
  • Fax: 321-843-6316
Mailing address:
  • Phone: 407-298-6950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number4301055819
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number080172
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number042.0012584
License Number StateVT
# 4
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME181399
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: