Provider Demographics
NPI:1598148678
Name:RENAMED LLC
Entity Type:Organization
Organization Name:RENAMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMAKKEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-676-0566
Mailing Address - Street 1:PO BOX 31966
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33420-1966
Mailing Address - Country:US
Mailing Address - Phone:561-676-0566
Mailing Address - Fax:
Practice Address - Street 1:210 JUPITER LAKES BLVD STE 3201
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7189
Practice Address - Country:US
Practice Address - Phone:561-948-3331
Practice Address - Fax:561-208-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
FL88718207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty