Eda Susan Renieri, MASTECTOMY FITTER

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

Practice address

517 East Strawbridge Ave
Melbourne, FL 32901

Phone

(321) 728-9442

Fax

(321) 728-9440

NPI assigned

Oct 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Eda Susan Peithman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1932285178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 EAST STRAWBRIDGE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-728-9442",
            "fax_number": "321-728-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 EAST STRAWBRIDGE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-728-9442",
            "fax_number": "321-728-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENIERI",
        "first_name": "EDA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MASTECTOMY FITTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224900000X",
            "taxonomy_group": "",
            "desc": "Mastectomy Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "M2733",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "44539000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDA",
            "last_name": "PEITHMAN",
            "middle_name": "SUSAN",
            "prefix": "MS.",
            "credential": "(MASTECTOMY FITTER)",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffy Aashee Reji, RBT
• Barbara Remington
• Brendan J Remus
• Renato M Durham MD PA
• Karl Rene, PA-C
• Mark Renner, MD
• Alexandra Renninger
• Ivory Tierra Renthrope III
• Jorge Requena Penenori, M.D
• Restorative Biotherapy PLLC

• Mastectomy Fitter in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Mastectomy Fitter in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.