RENEW THERAPY CENTER OF PALM BAY, LLC (NPI# 1316915184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316915184 |
| Entity Type | Organization |
| Organization Name | RENEW THERAPY CENTER OF PALM BAY, LLC |
| Other Organization Name | RENEW THERAPY CENTERS |
| Practice Address |
490 Centre Lake Dr Ne Suite 100 Palm Bay FL 32907-1189 |
| Practice Telephone | 3217689776 |
| Practice Fax Number | 3217689739 |
| Mailing Telephone | 3217689776 |
| Mailing Fax Number | 3217689739 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ALFONSO OCASIO (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 3217689776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Renew Therapy Centers | Other Name - Individual/Organization |
| Street Address |
490 CENTRE LAKE DR NE SUITE 100 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32907-1189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760484034 | David Williams | Emergency Medicine | 490 Centre Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 | 2005-06-01 |
| 1750903902 | John J Roberts | Hearing Instrument Specialist | 490 Centre Lake Dr Ne, Suite 150, Palm Bay, FL 32907 | 2020-05-11 |
| 1366710170 | Medfast Urgent Care Centers, LLC | Clinic/Center | 490 Centre Lake Dr Ne, Palm Bay, FL 32907-1113 | 2011-12-07 |
| 1023252368 | Shannon Patricia Green | Counselor | 490 Centre Lake Dr Ne, Suite 150, Palm Bay, FL 32907-1113 | 2009-04-30 |
| 1073639456 | Nomara Jeanne Buck | Physical Therapy Assistant | 490 Centre Lake Dr Ne, Suite 100, Palm Bay, FL 32907-1189 | 2007-03-21 |
| 1447341821 | Shawn Wilson | Physical Therapy Assistant | 490 Centre Lake Dr Ne, Palm Bay, FL 32907-1189 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015109 | Tyreak Albert Mclarty | Behavior Technician | 2180 Julian Ave Nw, Palm Bay, FL 32907 | 2020-05-21 |
| 1871073759 | Jessica Elizabeth Ford | Physical Therapist | 470 Malabar Rd Se Unit 102, Palm Bay, FL 32907 | 2018-08-20 |
| 1598264558 | Corey Williams | Case Management | 1850 Delki St. Nw, Palm Bay, FL 32907 | 2018-02-06 |
| 1386154904 | Lauren Nicole Meek | Social Worker | 550 Malabar Rd Sw Apt 202, Palm Bay, FL 32907 | 2017-10-10 |
| 1679002877 | Kandice Monique Hearns | Physical Therapy Assistant | 175 Ne Villa Nueva Ave, Palm Bay, FL 32907 | 2017-06-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1467992107 | Enrique Martinez | Counselor | 1510 Studley Dr. Nw, Palm Bay, FL 32907 | 2017-02-28 |
| 1144776469 | Stephanie Ann Hoenig | Physical Therapy Assistant | 1155 Malabar Rd Se, Palm Bay, FL 32907 | 2016-08-28 |
| 1124471529 | K & S Tender Care 11 | Assisted Living Facility | 226 Abalone Road Ne, Palm Bay, FL 32907 | 2016-07-20 |
| 1235507781 | Jai Ho LLC | Specialist | 1663 Georgia Street, Suite 400, Palm Bay, FL 32907 | 2015-09-14 |
| Find all providers in zip 32907 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960704 | Victoria Garcia | Clinic/Center | 1252 Nw 32nd St, Miami, FL 33142-6143 | 2020-04-06 |
| 1043846454 | Recovery Is Hope, LLC | Clinic/Center | 2512 W Cherry St Apt E, Tampa, FL 33607-3355 | 2020-03-17 |
| 1245750967 | Semper Therapy Center Inc | Clinic/Center | 8500 Sw 8th Street, Suite 224, Miami, FL 33144 | 2017-06-23 |
| 1477089274 | Sardonyx Group Therapy Inc | Clinic/Center | 4320 W Broward Blvd Ste 4, Plantation, FL 33317-3756 | 2017-05-11 |
| 1548637671 | Lilypad Counseling Services | Clinic/Center | 9589 Verona Lakes Blvd, Boynton Beach, FL 33472-2759 | 2015-08-24 |
| 1144619610 | Tnr Staffing, LLC | Clinic/Center | 6141 Lakae Worth Road, Lake Worth, FL 33463-3807 | 2015-01-21 |
| 1144562612 | Jl X Ray Options, Inc | Clinic/Center | 10340 Nw 36th Ct, Miami, FL 33147-1036 | 2013-03-22 |
| 1609122639 | Ariel Perez | Clinic/Center | 4070 Nw 5 St, Miami, FL 33126 | 2012-07-27 |
| 1942572805 | Instituto Medico Del Dolor LLC | Clinic/Center | 717 Ponce De Leon Blvd Ste 218, Coral Gables, FL 33134-2048 | 2012-02-07 |
| 1902174683 | Pulyterapia Spa Corp | Clinic/Center | 9369 Fountainbleau Blvd Apt J108, Miami, FL 33172-5629 | 2011-12-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.