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Individual

YANICK MAXENA RENEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10650 W STATE ROAD 84 STE 206, DAVIE, FL 33324-4235
(954) 634-3636
(954) 634-3637
Mailing address
2756 NW 1ST CT, POMPANO BEACH, FL 33069-2501
(954) 627-2513

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022917800
FL
Enumeration date
01/16/2018
Last updated
01/16/2018
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