# RENAISSANCE MEDICAL CENTER CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437691169
- **Authorized official:** AMILCAR M LOMINCHAR MD (MD/OWNER)
- **Authorized official phone:** (813) 440-4420

## Contact information

- **Practice address:** 3832 W HUMPHREY ST, TAMPA, FL 33614-1955
- **Practice address phone:** (813) 440-4420
- **Practice address fax:** (813) 502-0290
- **Mailing address:** 3832 W HUMPHREY ST, TAMPA, FL 33614-1955
- **Mailing address phone:** (813) 440-4420
- **Mailing address fax:** (813) 502-0290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | ME125313 | FL | — |

## Other

- **Enumeration date:** 11/11/2016
- **Last updated:** 06/05/2023