Provider Demographics
NPI:1437830171
Name:ELIZABETH M RENE PA
Entity Type:Organization
Organization Name:ELIZABETH M RENE PA
Other - Org Name:CENTER OF SPECIALIZED DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALME
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-428-7676
Mailing Address - Street 1:2830 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5738
Mailing Address - Country:US
Mailing Address - Phone:772-219-2224
Mailing Address - Fax:772-219-2216
Practice Address - Street 1:2830 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5738
Practice Address - Country:US
Practice Address - Phone:772-219-2224
Practice Address - Fax:772-219-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty