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General NPI Number Information
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NPI Number | 1609018886
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Entity Type | Organization
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Legal Business Name | RENAISSANCE HEALTH SYSTEM OF FLORIDA, INC.
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location 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 |
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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 |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. 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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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