CRYSTAL RAYE RENAUD (NPI# 1770132904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770132904 |
| Entity Type | Individual |
| Full Name | CRYSTAL RAYE RENAUD |
| Credential | APRN |
| Practice Address |
1110 Druid Cir Lake Wales FL 33853-4307 |
| Mailing Address |
7932 W Sand Lake Rd Ste 202 Orlando FL 32819-7299 |
| Practice Telephone | 8008277546 |
| Mailing Telephone | 8008277546 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11003936 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2205 North Blvd W, Davenport, FL 338378933 | 8008277546 | |
| 339 Cypress Pkwy Ste 110, Poinciana, FL 347593315 | 8008277546 |
| Street Address |
1110 DRUID CIR |
| City | LAKE WALES |
| State | FL |
| Zip Code | 33853-4307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518964873 | James A Nelson | Family Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2005-07-01 |
| 1659884096 | Nakisha Lavon Watson | Family Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2017-11-07 |
| 1891187159 | William J Barringer | Family Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2015-02-24 |
| 1063849248 | Lake Wales Urology, LLC | Urology | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2013-10-02 |
| 1881710135 | Barringer,nelson & Holmes Pa | Family Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2007-03-21 |
| 1124188180 | Mahesh Gandhi Allam | Internal Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2006-12-11 |
| 1356429690 | William Barringer | Family Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2006-11-02 |
| 1124049317 | Medical Associates of Central Florida | Internal Medicine | 1110 Druid Cir, Lake Wales, FL 33853-4307 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218998 | Marcel Fundora | Dentist | 701 Fl-60, Lake Wales, FL 33853 | 2020-06-04 |
| 1386291599 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 1255 Florida 60, Suite 300, Lake Wales, FL 33853 | 2019-08-22 |
| 1932753472 | Adeline Brooke Warren | Occupational Therapist | 512 S 11th Street, Lake Wales, FL 33853 | 2019-08-01 |
| 1033563580 | Amber Y Shepard | Family Medicine | 1255 Highway 60 E Ste 500, Lake Wales, FL 33853 | 2016-04-21 |
| 1174982458 | Ledesha Marie Dorothy Maduro | Dentist | 24185 Us Hwy 27 North, Lake Wales, FL 33853 | 2016-02-16 |
| 1528402435 | Buck Andreu Scott | Surgery | 407 S 11th St, Lake Wales, FL 33853 | 2013-04-22 |
| 1447598321 | Central Florida Health Care, Inc. | Dentist | 305 West Central Avenue, Lake Wales, FL 33853 | 2013-01-28 |
| 1972864932 | Kevin T Barlow, Pa. Dba: Winter Haven Audiology and Ridge Audiology. | Clinic/Center | 704 Sr 60 East, Lake Wales, FL 33853 | 2012-06-06 |
| 1316266364 | Elba M Lopez | Massage Therapist | 318 S. First Street, Lake Wales, FL 33853 | 2010-05-28 |
| 1063657955 | Lake Wales Medical Imaging Center One, Inc | Technician, Health Information | 1255 Highway 60 East 110, Lake Wales, FL 33853 | 2008-12-08 |
| Find all providers in zip 33853 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326684713 | Ralph Edward Weaver IIi | Nurse Practitioner | 825 Hickory Hammock Rd, Lake Wales, FL 33859-7742 | 2019-11-21 |
| 1881051894 | Deanna Larr | Nurse Practitioner | 809 Hunt Dr, Lake Wales, FL 33853-3542 | 2016-01-21 |
| 1720485170 | Lisa Marie Peto | Nurse Practitioner | 24165 Hwy 27, Lake Wales, FL 33859-7819 | 2014-12-01 |
| 1669085411 | Whitney Scott Brown | Nurse Practitioner | 1137 Druid Cir, Lake Wales, FL 33853-4339 | 2020-08-30 |
| 1023581436 | Jenna Leigh Tillett | Nurse Practitioner | 1354 State Road 60 E, Lake Wales, FL 33853-4322 | 2019-01-08 |
| 1841773140 | Kristy Laine Oneill | Nurse Practitioner | 851 Chalet Suzanne Rd, Lake Wales, FL 33859-7759 | 2018-09-12 |
| 1992259477 | Dawn Michelle Shepard | Nurse Practitioner | 410 S 11th St, Lake Wales, FL 33853-4203 | 2016-08-12 |
| 1578532669 | Anna K Moreau | Nurse Practitioner | 305 W Central Ave, Lake Wales, FL 33853-4015 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588413 | Arnol Miguel Chacon Chacon | Nurse Practitioner | 1001 Rich Dr, Palm Springs, FL 33406-6508 | 2020-11-08 |
| 1427659192 | Monica Teresita Vengoechea Leon | Nurse Practitioner | 68 Se 6th St Apt 4104, Miami, FL 33131-3519 | 2020-11-08 |
| 1740881416 | Donald Douglass Jamieson | Nurse Practitioner | 17929 Hunting Bow Cir # Na, Lutz, FL 33558-5378 | 2020-11-08 |
| 1609477348 | Danielle Schmidt | Nurse Practitioner | 7803 34th Ct E, Sarasota, FL 34243-2867 | 2020-11-07 |
| 1083215735 | Ahecio Alexander Labrada Izquierdo | Nurse Practitioner | 624 Sw 132nd Ter, Davie, FL 33325-3242 | 2020-11-07 |
| 1114528874 | Wandering Michelle, LLC | Nurse Practitioner | 526 Wekiva Bluff St, Apopka, FL 32712-2776 | 2020-11-07 |
| 1508467325 | Digna Maria Espinosa | Nurse Practitioner | 13655 Sw 2nd St, Miami, FL 33184-1049 | 2020-11-06 |
| 1265033005 | Lourdes Milagros Rivera | Nurse Practitioner | 4512 Raintree Ridge Rd, Orlando, FL 32837-5133 | 2020-11-06 |
| 1023619913 | Ana Maria Guerra Garcia | Nurse Practitioner | 802 Windsor Cir, Brandon, FL 33510-2927 | 2020-11-05 |
| 1891396818 | Gilberto Fernandez Sr. | Nurse Practitioner | 8021 Nw 166th St, Miami Lakes, FL 33016-3421 | 2020-11-05 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WALES |
| Zip Code | 33853 |
Please comment or provide details below to improve the information on CRYSTAL RAYE RENAUD.
| 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.