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NPI Code Detail

MEDICARE: DANIEL R. RENUART, MD, PA

MEDICARE: DANIEL R. RENUART, MD, PA
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
1208000000XPediatrics PhysicianME70353FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801900451
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANIEL R. RENUART, MD, PA
Provider Business Mailing Address
First Line : 2506 SAND MINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33897-3402
Country : US
Telephone Number : 863-424-8966
Fax Number : 863-424-8825
Provider Business Practice Location Address
First Line : 2506 SAND MINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33897-3402
Country : US
Telephone Number : 863-424-8966
Fax Number : 863-424-8825
Authorized Official
Title or Position : PRESIDENT
Name : DANIEL ROBERT RENUART
Credential : M.D.
Telephone Number : 863-424-8966
Provider Enumeration Date : 08/19/2006
Last Update Date : 10/19/2011

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