Renew Therapy Center of Port St. Lucie , LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

HCC3926 Issued in FL

Legal business name

RENEW THERAPY CENTER OF PORT ST. LUCIE , LLC

Practice address

1854 SE Port St Lucie Blvd
Fort Pierce, FL 34952-5545

Phone

(772) 501-8804

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Lazaro Hernandez

Title

Owner

Phone

(772) 501-8804

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1821022815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1854 SE PORT ST LUCIE BLVD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-501-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1854 SE PORT ST LUCIE BLVD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-501-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW THERAPY CENTER OF PORT ST. LUCIE , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "LAZARO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-501-8804",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "HCC3926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Restoration Ministries, Inc.

• Physical Therapy Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.