NPIMap

Organization Active NPI

Daniel R. Renuart, M.D., P.a.

Doing business as Railroad Park Pediatrics and Four Corners Pediatrics

  • Pediatrics Physician
  • Haines City, FL
National Provider Identifier
1346206935
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME70353 Issued in FL
Legal business name
DANIEL R. RENUART, M.D., P.A.
Doing business as
Railroad Park Pediatrics and Four Corners Pediatrics
Practice address
900 Ingraham Ave
Haines City, FL 33844-4336
Phone
(863) 421-6565
Fax
(863) 421-7474
NPI assigned
Apr 24, 2006
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Daniel Robert Renuart, M.D.NPI 1629034673
Title
President
Phone
(863) 421-6565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME70353 FL Primary

Addresses

Primary practice location

900 Ingraham Ave
Haines City, FL 33844-4336

Mailing address

900 Ingraham Ave
Haines City, FL 33844-4336
Phone (863) 421-6565

Other identifiers 3

IdentifierTypeStateIssuer
272383201MedicaidFL
74525OtherFLBLUE CROSS BLUE SHIELD #
272383200MedicaidFL

Other names 1

  • RAILROAD PARK PEDIATRICS AND FOUR CORNERS PEDIATRICS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Daniel R Renuart MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

900 Ingraham Ave
Haines City, FL 33844
Phone (863) 421-6565

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1346206935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444336",
            "telephone_number": "863-421-6565",
            "fax_number": "863-421-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444336",
            "telephone_number": "863-421-6565",
            "fax_number": "863-421-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL R. RENUART, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "RENUART",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-421-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME70353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272383201",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "74525",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272383200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAILROAD PARK PEDIATRICS AND FOUR CORNERS PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haines City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.