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General NPI Number Information
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NPI Number | 1942172499
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Entity Type | Organization
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Legal Business Name | RENOVA PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1875 STEVENSON AVE
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City | CLEARWATER
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State | FL
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Zip | 33755-1856
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Country | US
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Telephone | 727-314-2343
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Fax |
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Provider Business Mailing Address
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Address Line | 1875 STEVENSON AVE
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City | CLEARWATER
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State | FL
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Zip | 33755-1856
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Country | US
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Telephone | 727-314-2343
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | NATHAN VALTIN
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Credential | PT, DPT
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Telephone | 727-656-7595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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