Provider Demographics
NPI:1699758391
Name:RENAISSANCE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:RENAISSANCE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CELSO
Authorized Official - Middle Name:EFREN
Authorized Official - Last Name:MOSQUERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-233-4477
Mailing Address - Street 1:14680 SW 8TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3138
Mailing Address - Country:US
Mailing Address - Phone:305-233-4477
Mailing Address - Fax:305-233-7117
Practice Address - Street 1:14680 SW 8TH ST STE 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-3138
Practice Address - Country:US
Practice Address - Phone:305-233-4477
Practice Address - Fax:305-233-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991960251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651057400Medicaid
FL651057400Medicaid