=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336531318
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RHEUMATOLOGY AND ENDOCRINOLOGY SPECIALISTS OF THE PALM BEACHES, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2015
-----------------------------------------------------
Last Update Date | 02/27/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5155 CORPORATE WAY C
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-4356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-358-9689
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 112 SANDBOURNE LN
-----------------------------------------------------
City | PALM BEACH GARDENS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33418-8086
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-358-9689
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. RENANIT BARRON
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 561-358-9689
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | ME79307
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------