Provider Demographics
NPI:1134650898
Name:LARWETH, RENEE (CNA)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:LARWETH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 CANDLER DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-9670
Mailing Address - Country:US
Mailing Address - Phone:407-227-5521
Mailing Address - Fax:
Practice Address - Street 1:2635 CANDLER DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-9670
Practice Address - Country:US
Practice Address - Phone:407-227-5521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL298666376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide