Organization Active NPI

Renaissance Rejuvenating Medicine Inc

  • Multi-Specialty Clinic/Center
  • Cape Coral, FL
National Provider Identifier
1528543725
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RENAISSANCE REJUVENATING MEDICINE INC
Practice address
629 SW 4TH St
Cape Coral, FL 33991-1971
Phone
(239) 800-3028
Fax
(239) 599-4893
NPI assigned
Oct 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Alfonso Garcia Bello, MDNPI 1093972713
Title
President
Phone
(239) 800-3028

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Research Clinic/Center 261QR1100X

Addresses

Primary practice location

629 SW 4TH St
Cape Coral, FL 33991-1971

Mailing address

629 SW 4TH St
Cape Coral, FL 33991-1971
Phone (239) 800-3028

National Provider Directory

National Provider Directory

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": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1528543725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 SW 4TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339911971",
            "telephone_number": "239-800-3028",
            "fax_number": "239-599-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 SW 4TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339911971",
            "telephone_number": "239-800-3028",
            "fax_number": "239-599-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE REJUVENATING MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "GARCIA BELLO",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-800-3028",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

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