Individual provider Active NPI

Renelle Simone Romano, MD

  • Pediatrics Physician
  • North Miami, FL
National Provider Identifier
1730686981
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME148789 Issued in FL
Practice address
11645 Biscayne Blvd Ste 103
North Miami, FL 33181-3138
Phone
(305) 538-8835
Fax
(305) 994-0054
NPI assigned
Apr 12, 2018
Reactivated
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME148789 FL Primary

Addresses

Primary practice location

11645 Biscayne Blvd Ste 103
North Miami, FL 33181-3138

Mailing address

11645 Biscayne Blvd Ste 207
North Miami, FL 33181-3138
Phone (305) 538-8835

Other practice location 1

710 Alton Rd
Miami Beach, FL 33139-5504
Phone (305) 538-8835

Other practice location 2

1221 71st St
Miami Beach, FL 33141-3647
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
111076500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723002402 FL Practitioner - Pediatric Medicine 1850794140 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Beach Community Health Center Inc Current Accepting new patients
Miami Beach Community Health Center Inc CurrentSince Jul 16, 2021 Accepting new patients
Miami Beach Community Health Center Inc CurrentSince Jul 16, 2021 Accepting new patients

Locations

1221 71st St
Miami Beach, FL 33141

710 Alton Rd
Miami Beach, FL 33139

11645 Biscayne Blvd
Ste 103
North Miami, FL 33181

11645 Biscayne Blvd
Ste 308
North Miami, FL 33181
Phone (305) 895-0010

11645 Biscayne Blvd
Ste 207
North Miami, FL 33181
Phone (704) 297-9229

11645 Biscayne Blvd
Ste 408
North Miami, FL 33181

11645 Biscayne Blvd
Ste 309
North Miami, FL 33181
Phone (867) 920-2021

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1730686981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 103",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331395504",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 71st St",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331413647",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMANO",
        "first_name": "RENELLE",
        "middle_name": "SIMONE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "deactivation_date": "2018-11-16",
        "reactivation_date": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME148789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111076500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.