Provider Demographics
NPI:1285397893
Name:RENAISSANCE HEARING CENTER, LLC
Entity type:Organization
Organization Name:RENAISSANCE HEARING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:HAS
Authorized Official - Phone:352-461-0219
Mailing Address - Street 1:322 SHOPPING CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-4533
Mailing Address - Country:US
Mailing Address - Phone:352-461-0219
Mailing Address - Fax:
Practice Address - Street 1:322 SHOPPING CENTER DR
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-4533
Practice Address - Country:US
Practice Address - Phone:352-461-0219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech