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General NPI Number Information
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NPI Number | 1114068004
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Entity Type | Organization
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Legal Business Name | RENAISSANCE HOSPITAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8660 W FLAGLER ST SUITE 200
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City | MIAMI
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State | FL
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Zip | 33144-2031
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Country | US
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Telephone | 561-798-9800
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Fax | 561-296-3456
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Provider Business Mailing Address
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Address Line | 3420 FAIRLANE FARMS RD SUITE C
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City | WELLINGTON
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State | FL
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Zip | 33414-8701
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Country | US
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Telephone | 561-798-9800
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Fax | 561-296-3456
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | NOEL J GUILLAMA
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Credential |
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Telephone | 561-798-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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