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NPI Code Detail

MEDICARE: JEAN LAVENTURE RENELIEN

MEDICARE: JEAN LAVENTURE RENELIEN
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
1174400000XSpecialistME 86189FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME86189OTHERFLLICENSE NUMBER

General Provider Information

NPI Number : 1639125396
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEAN LAVENTURE RENELIEN
Provider Business Mailing Address
First Line : 7315 W FLAGLER ST
Second Line :
City : MIAMI
State : FL
Zip : 33144-2505
Country : US
Telephone Number : 305-261-9221
Fax Number : 305-261-9447
Provider Business Practice Location Address
First Line : 7315 W FLAGLER ST
Second Line :
City : MIAMI
State : FL
Zip : 33144-2505
Country : US
Telephone Number : 305-261-9221
Fax Number : 305-261-9447
Authorized Official
Title or Position : M.D.
Name : JEAN LAVENTURE RENELIEN
Credential : M.D
Telephone Number : 305-261-9221
Provider Enumeration Date : 05/25/2006
Last Update Date : 08/22/2020

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Directions to “JEAN LAVENTURE RENELIEN ” Practice Location

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