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Organization
RENAISSANCE MEDICAL GROUP PR CORPORATION
Active
Organization
RENAISSANCE MEDICAL GROUP PR CORPORATION
Active
Other names
Renaissance Medical Group PR
Organization subpart
No
Provider details
NPI number
Authorized official
LISSETTE GUZMAN (EXECUTIVE DIRECTOR)
(774) 318-1400
Entity
Organization
Contact information
Practice address
406 COCO BEACH BLVD APT D402, RIO GRANDE, PR 00745-4020
(774) 420-2311
(508) 462-0287
Mailing address
11-15 SANDERSDALE ROAD, SOUTHBRIDGE, MA 01550-2855
(774) 318-1400
(508) 462-0287
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
Other
Enumeration date
10/04/2024
Last updated
07/15/2025
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