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General NPI Number Information
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NPI Number | 1285397893
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Entity Type | Organization
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Legal Business Name | RENAISSANCE HEARING CENTER, LLC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 322 SHOPPING CENTER DR
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City | WILDWOOD
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State | FL
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Zip | 34785-4533
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Country | US
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Telephone | 352-461-0219
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Fax |
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Provider Business Mailing Address
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Address Line | 322 SHOPPING CENTER DR
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City | WILDWOOD
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State | FL
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Zip | 34785-4533
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Country | US
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Telephone | 352-461-0219
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ANGELO DARBY
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Credential | H.A.S.
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Telephone | 352-461-0219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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