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General NPI Number Information
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NPI Number | 1932916244
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Entity Type | Organization
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Legal Business Name | RENEWED RIVADENEIRA MEDICAL CENTER INC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 12490 NE 7TH AVE STE 200
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5660
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Country | US
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Telephone | 786-417-4389
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Fax |
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Provider Business Mailing Address
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Address Line | 12490 NE 7TH AVE STE 200
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL P LOREN
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Credential | M.D
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Telephone | 786-417-4389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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