Individual
CARLA ROCHELLE RENALDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1301 2ND AVE SW, LARGO, FL 33770-3120
(727) 581-8767
(727) 588-9478
Mailing address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(727) 581-8767
(727) 588-9478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS12089
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009258700
—
FL
01
—
14R7J
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/09/2010
Last updated
01/10/2019
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