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Organization

RENEW THERAPY CENTER OF PORT ST. LUCIE , LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LAZARO HERNANDEZ (OWNER)
(772) 501-8804
Entity
Organization

Contact information

Practice address
1854 SE PORT ST LUCIE BLVD, FORT PIERCE, FL 34952-5545
(772) 501-8804
Mailing address
1854 SE PORT ST LUCIE BLVD, FORT PIERCE, FL 34952-5545
(772) 501-8804

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
HCC3926
FL

Other

Enumeration date
07/10/2006
Last updated
12/02/2009
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