| Renova Internal Medicine | |
|
710 Denbigh Blvd Ste 7b Newport News VA 23608-4427 | |
| (787) 340-8175 | |
| Not Available |
| Full Name | Renova Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 710 Denbigh Blvd Ste 7b, Newport News, Virginia |
| Authorized Official Name and Position | Yazmin Johanna Soto Guerrero (PRESIDENT) |
| Authorized Official Contact | 7873408175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renova Internal Medicine 304 Blevins Run Yorktown VA 23693-4188 Ph: (787) 340-8175 | Renova Internal Medicine 710 Denbigh Blvd Ste 7b Newport News VA 23608-4427 Ph: (787) 340-8175 |
| NPI Number | 1255781977 |
|---|---|
| Provider Enumeration Date | 06/14/2016 |
| Last Update Date | 08/11/2016 |
| Medicare PECOS PAC ID | 3072807437 |
|---|---|
| Medicare Enrollment ID | O20160808000905 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255781977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101260290 (Virginia) | Primary |
| Provider Name | Yazmin J Soto Guerrero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104866482 PECOS PAC ID: 3779580428 Enrollment ID: I20160808001082 |
| Provider Name | Gerardo Rivera Roman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033461934 PECOS PAC ID: 0547407975 Enrollment ID: I20160810000521 |
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