Renee Nicole Reynolds, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 19484 Issued in FL

Practice address

220 N Sykes Creek Pkwy
Suite 200
Merritt Island, FL 32953-3490

Phone

(321) 459-1446

NPI assigned

Nov 18, 2007

Last updated

May 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Renee Largent Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1195344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1689855678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N SYKES CREEK PKWY",
            "address_2": "SUITE 200",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N SYKES CREEK PKWY",
            "address_2": "SUITE 200",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533490",
            "telephone_number": "321-459-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "RENEE",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-18",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 19484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "LARGENT",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yunileydys Reina
• Rejuvenate With Grace, Inc.
• Restoration Medicine LLC
• Diana Harris Revolinski, RN
• Michelle Christina-Lani Reynolds, COTA
• Ricardo a Serrano MD LLC
• Nicholas Rich
• Richard Baratta, DDS, PA
• Richard P Newman MD PA
• Kendra Marie Richardson, LCSW

• Physical Therapy Assistant in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.