Provider Demographics
NPI:1093505158
Name:RENEW HORMONE THERAPY LLC
Entity type:Organization
Organization Name:RENEW HORMONE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:DR
Authorized Official - First Name:JHONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:407-686-9611
Mailing Address - Street 1:364 NORTHPOINTE CT UNIT 108
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5811
Mailing Address - Country:US
Mailing Address - Phone:407-686-9611
Mailing Address - Fax:
Practice Address - Street 1:364 NORTHPOINTE CT UNIT 108
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5811
Practice Address - Country:US
Practice Address - Phone:407-686-9611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care