Provider Demographics
NPI:1942821699
Name:RENEWU
Entity Type:Organization
Organization Name:RENEWU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-331-2983
Mailing Address - Street 1:1411 N FLAGLER DR STE 9000
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3421
Mailing Address - Country:US
Mailing Address - Phone:561-331-2983
Mailing Address - Fax:561-331-2984
Practice Address - Street 1:1411 N FLAGLER DR STE 9000
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3421
Practice Address - Country:US
Practice Address - Phone:561-331-2983
Practice Address - Fax:561-331-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty