Organization
ARDENT FAMILY CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENATO ASCENSIO ALFONSO M.D. (PRESIDENT)
(386) 439-9777
Entity
Organization
Contact information
Practice address
84 PINNACLES DR STE 200, PALM COAST, FL 32164-2324
(386) 439-9777
(386) 206-0015
Mailing address
84 PINNACLES DR STE 200, PALM COAST, FL 32164-2324
(386) 439-9777
(386) 206-0015
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D049
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253950100
—
FL
Enumeration date
09/06/2006
Last updated
07/15/2009
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