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General NPI Number Information
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NPI Number | 1255334074
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Entity Type | Organization
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Legal Business Name | RENEWAL MEDICAL SPECIALISTS
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6655 VIA REGINA
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City | BOCA RATON
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State | FL
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Zip | 33433-3920
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Country | US
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Telephone | 954-914-9199
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Fax |
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Provider Business Mailing Address
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Address Line | 6655 VIA REGINA
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City | BOCA RATON
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State | FL
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Zip | 33433-3920
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Country | US
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Telephone | 954-914-9199
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL JOHN ARUTA
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Credential | MD
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Telephone | 954-929-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME59850
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License Number State | FL
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