Provider Demographics
NPI:1659139566
Name:REJUVA CARERX
Entity Type:Organization
Organization Name:REJUVA CARERX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:H
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-933-1885
Mailing Address - Street 1:33618 DOLORES CT
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3823
Mailing Address - Country:US
Mailing Address - Phone:352-933-1885
Mailing Address - Fax:
Practice Address - Street 1:33618 DOLORES CT
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3823
Practice Address - Country:US
Practice Address - Phone:352-933-1885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care