MEDICARE: RENEWAL MEDICAL SPECIALISTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	ME59850	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6767583	OTHER	FL	UNITED HEALTH CARE
2	14368	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1255334074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEWAL MEDICAL SPECIALISTS

Provider Business Mailing Address
First Line	:	6655 VIA REGINA
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3920
Country	:	US
Telephone Number	:	954-914-9199
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 VIA REGINA
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3920
Country	:	US
Telephone Number	:	954-914-9199
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL JOHN ARUTA
Credential	:	MD
Telephone Number	:	954-929-1200

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/07/2023

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Directions to “RENEWAL MEDICAL SPECIALISTS ” Practice Location

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