Provider Demographics
NPI:1285143347
Name:F5 SURGICAL - ROBIN RENTERIA LLC
Entity type:Organization
Organization Name:F5 SURGICAL - ROBIN RENTERIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-676-7398
Mailing Address - Street 1:PO BOX 744365
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4365
Mailing Address - Country:US
Mailing Address - Phone:770-676-7398
Mailing Address - Fax:404-855-4243
Practice Address - Street 1:5425 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-6536
Practice Address - Country:US
Practice Address - Phone:770-676-7398
Practice Address - Fax:404-855-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62046208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty