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Contact Information

REJUVA MED
28945 STATE ROAD 54
SUITE 101
WESLEY CHAPEL, FL33543
 Phone: 813-907-0950
 Fax: 813-907-7949
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for REJUVA MED

NPI Number 1629443643
LBN Legal business name REJUVA MED
Authorized official KENNETH ANDRONICO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/02/2015
Last updated 12/02/2015 - About 11 years ago
Identifiers
FL License # OS004967
FL Medicaid 013795600
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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