Rejuva Med

Primary specialty

OptometristTaxonomy code 152W00000X

License

OS004967 Issued in FL

Legal business name

REJUVA MED

Practice address

28945 State Road 54
Suite 101
Wesley Chapel, FL 33543

Phone

(813) 907-0950

Fax

(813) 907-7949

NPI assigned

Dec 2, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Andronico, D.O.NPI 1134398167

Title

Owner

Phone

(813) 907-0950

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kenneth C. Andronico, D.O.

  • Public Health & General Preventive Medicine Physician
  • Wesley Chapel, FL
  • NPI 1134398167
  NPD (past) Authorized official

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1629443643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28945 STATE ROAD 54",
            "address_2": "SUITE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33543",
            "telephone_number": "813-907-0950",
            "fax_number": "813-907-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28945 STATE ROAD 54",
            "address_2": "SUITE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33543",
            "telephone_number": "813-907-0950",
            "fax_number": "813-907-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVA MED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "ANDRONICO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-907-0950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OS004967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013795600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joni Lee Reeves-Woodruff, BCBA
• Chris B Reifenstein, PA
• Rachael Reilly, PA-C
• Rebecca Reimann, PTA
• Benjamin Steven Reimer, DO
• Reliance Home Care, LLC
• Kelsey Ann Renke
• Resilient Rose Wellness LLC
• Revamp Care LLC
• Revitalize Psychiatric Services II, Inc.

• Optometrist in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.