Renew the Breast Care Boutique Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

RENEW THE BREAST CARE BOUTIQUE INC

Practice address

5601 Okeechobee Blvd
Suite C
West Palm Beach, FL 33417-4489

Phone

(561) 328-7434

NPI assigned

Nov 17, 2015

Organization subpart

No

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

Authorized official

Name

David Light

Title

Vice President

Phone

(561) 876-4022

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelley Hinson Light, PT

  • Physical Therapist
  • West Palm Beach, FL
  • NPI 1407890858
  NPD (past)

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1487028296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 OKEECHOBEE BLVD",
            "address_2": "SUITE C",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 OKEECHOBEE BLVD",
            "address_2": "SUITE C",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174489",
            "telephone_number": "561-328-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW THE BREAST CARE BOUTIQUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "561-876-4022"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Withney Renaud
• Arianna Rendon Albalat, RBT-25-422215
• Nellie Esther Rendon, LMT
• Yusnelis Rendon
• Renes Castor MD PA
• Renew You Palm Beach, LLC
• Renewed Wellness Medical Center LLC
• Renewu
• Mary Renner, OTR/L
• Replenish and Renew Counseling LLC

• All providers in West Palm Beach, FL
• Customized Equipment (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.