| Renaissance Medical Group Inc | |
|
629 Sw 4th St Cape Coral FL 33991-1971 | |
| (239) 800-3028 | |
| (239) 599-4893 |
| Full Name | Renaissance Medical Group Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 629 Sw 4th St, Cape Coral, Florida |
| Authorized Official Name and Position | Alfonso Garcia Bello (PRESIDENT) |
| Authorized Official Contact | 2398003028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Medical Group Inc 629 Sw 4th St Cape Coral FL 33991-1971 Ph: (239) 800-3028 | Renaissance Medical Group Inc 629 Sw 4th St Cape Coral FL 33991-1971 Ph: (239) 800-3028 |
| NPI Number | 1528645009 |
|---|---|
| Provider Enumeration Date | 03/29/2021 |
| Last Update Date | 03/29/2021 |
| Medicare PECOS PAC ID | 7416366638 |
|---|---|
| Medicare Enrollment ID | O20210429000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528645009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Nelson Alvarez Reyes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912186354 PECOS PAC ID: 2466524400 Enrollment ID: I20080708000261 |
| Provider Name | Alfonso Garcia Bello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093972713 PECOS PAC ID: 6002087723 Enrollment ID: I20110928000704 |
| Provider Name | Yanet Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912398587 PECOS PAC ID: 2163732850 Enrollment ID: I20151109002318 |
| Provider Name | Johally Ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174040794 PECOS PAC ID: 6002249711 Enrollment ID: I20191211002037 |
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