Provider Demographics
NPI:1306928924
Name:RENE, CATHIA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CATHIA
Middle Name:MARIE
Last Name:RENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 OKEECHOBEE BLVD
Mailing Address - Street 2:APT 1405
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6317
Mailing Address - Country:US
Mailing Address - Phone:352-278-8191
Mailing Address - Fax:
Practice Address - Street 1:5065 SOUTH STATE ROAD 7
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449
Practice Address - Country:US
Practice Address - Phone:561-753-7487
Practice Address - Fax:561-753-8161
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN 9049207RG0100X
FLME102056207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9049OtherTRN
FL000290900Medicaid
FL9049OtherTRN
FL000290900Medicaid