MEDICARE: RENACER HOME CARE CORP

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1497993976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENACER HOME CARE CORP

Provider Business Mailing Address
First Line	:	644-642 SE 4TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5432
Country	:	US
Telephone Number	:	305-885-2545
Fax Number	:	305-885-5022

Provider Business Practice Location Address
First Line	:	644-642 SE 4TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5432
Country	:	US
Telephone Number	:	305-885-2545
Fax Number	:	305-885-5022

Authorized Official
Title or Position	:	OWNER
Name	:	ADRIAN LOPEZ TRUY
Credential	:
Telephone Number	:	786-426-8577

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	03/03/2023

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Directions to “RENACER HOME CARE CORP ” Practice Location

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