Organization Active NPI

Renuva Wellness LLC

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1487326476
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
RENUVA WELLNESS LLC
Practice address
8910 Miramar Pkwy Ste 200
Miramar, FL 33025-4963
Phone
(305) 709-8343
NPI assigned
Sep 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Ms. Elsa Ashley Frederic, FNP-BC
Title
Provider
Phone
(786) 718-3813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

8910 Miramar Pkwy Ste 200
Miramar, FL 33025-4963

Mailing address

8910 Miramar Pkwy Ste 200
Miramar, FL 33025-4963

National Provider Directory

National Provider Directory

Locations

8910 Miramar Pkwy
Ste 200
Miramar, FL 33025
Phone (305) 709-8343

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1487326476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 MIRAMAR PKWY STE 200",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330254963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 MIRAMAR PKWY STE 200",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330254963",
            "telephone_number": "305-709-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENUVA WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "FREDERIC",
        "authorized_official_first_name": "ELSA",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "786-718-3813",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.