| Renace Llc | |
|
2200 Tucker Ln Apt B3 Gwynn Oak MD 21207-7835 | |
| (410) 892-3711 | |
| (855) 541-3197 |
| Full Name | Renace Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2200 Tucker Ln Apt B3, Gwynn Oak, Maryland |
| Authorized Official Name and Position | Maria Loreto Miranda Bravo (PRESIDENT) |
| Authorized Official Contact | 4108923711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renace Llc 2200 Tucker Ln Apt B3 Gwynn Oak MD 21207-7835 Ph: (410) 892-3711 | Renace Llc 2200 Tucker Ln Apt B3 Gwynn Oak MD 21207-7835 Ph: (410) 892-3711 |
| NPI Number | 1588402978 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588402978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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