Provider Demographics
NPI:1578540548
Name:RENARDSON, RICHARD REEVE (CFA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:REEVE
Last Name:RENARDSON
Suffix:
Gender:M
Credentials:CFA
Other - Prefix:
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Mailing Address - Street 1:908 PERRIN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-2356
Mailing Address - Country:US
Mailing Address - Phone:863-299-2525
Mailing Address - Fax:863-299-2525
Practice Address - Street 1:908 PERRIN AVE NW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-2356
Practice Address - Country:US
Practice Address - Phone:863-299-2525
Practice Address - Fax:863-299-2525
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist