Healthcare Provider Details

I. General information

NPI: 1437830171
Provider Name (Legal Business Name): ELIZABETH M RENE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 04/17/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 SE FEDERAL HWY
STUART FL
34994-5738
US

IV. Provider business mailing address

2830 SE FEDERAL HWY
STUART FL
34994-5738
US

V. Phone/Fax

Practice location:
  • Phone: 772-219-2224
  • Fax: 772-219-2216
Mailing address:
  • Phone: 772-219-2224
  • Fax: 772-219-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH M VALME
Title or Position: ENDODONTIST
Credential: DDS
Phone: 407-428-7676