Provider Demographics
NPI:1407163728
Name:INFECTIONS MANAGED INC
Entity Type:Organization
Organization Name:INFECTIONS MANAGED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RENAE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-776-9992
Mailing Address - Street 1:3012 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4356
Mailing Address - Country:US
Mailing Address - Phone:954-776-9992
Mailing Address - Fax:954-776-9993
Practice Address - Street 1:3012 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4356
Practice Address - Country:US
Practice Address - Phone:954-776-9992
Practice Address - Fax:954-776-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63353207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003165300Medicaid
FLEL575AMedicare PIN