Individual
RICHARD CHARLES RENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
990 AIRPORT ROAD, PEDIATRIC DEPARTMENT, DESTIN, FL 32541
(850) 269-6400
(850) 654-9581
Mailing address
990 AIRPORT ROAD, PEDIATRIC DEPARTMENT, DESTIN, FL 32541
(850) 269-6400
(850) 654-9581
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME79721
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251905900
—
FL
01
—
58890
FLORIDA BLUE
FL
Enumeration date
08/17/2006
Last updated
06/20/2013
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