Provider Demographics
NPI:1952899312
Name:DOLMEUS, RENAND SR
Entity Type:Individual
Prefix:
First Name:RENAND
Middle Name:
Last Name:DOLMEUS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 S AUSTRALIAN AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6447
Mailing Address - Country:US
Mailing Address - Phone:561-727-5274
Mailing Address - Fax:
Practice Address - Street 1:1818 SOUTH AUSTRALIAN AVE.
Practice Address - Street 2:SUITE 420
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:185-583-2672
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPBSPB12018106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst