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General NPI Number Information
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NPI Number | 1912104407
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Entity Type | Individual
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Provider Name | RENEE F. LITVAK D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 3001 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308
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Country | US
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Telephone | 954-491-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 5899 NW 25TH CT
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City | BOCA RATON
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State | FL
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Zip | 33496
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Country | US
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Telephone | 917-359-9781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 050403
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN21142
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License Number State | FL
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