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General NPI Number Information
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NPI Number | 1184502502
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Entity Type | Organization
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Legal Business Name | RENEW WELNESS OF BOCA LLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 499 E PALMETTO PARK RD STE 207
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City | BOCA RATON
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State | FL
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Zip | 33432-5081
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Country | US
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Telephone | 678-799-1669
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Fax |
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Provider Business Mailing Address
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Address Line | 499 E PALMETTO PARK RD STE 207
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City | BOCA RATON
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State | FL
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Zip | 33432-5081
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Country | US
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Telephone | 678-799-1669
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Fax |
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Authorized Official
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Title or Position | OFFICE CONSULTANT
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Name | MRS. FARAH BAUDIN
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Credential |
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Telephone | 786-277-1621
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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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