Renner, Mark
Renner, Mark is an individual health care provider with primary practice located at 400 E Sheridan Rd , Melbourne FL 32901-3122. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Renner, Mark can be contacted via phone (321) 722-5200.Contact Information
Primary practice address
400 E Sheridan Rd
Melbourne FL 32901-3122
Phone: (321) 722-5200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME0083607 | Florida |
Profile Details
| NPI number | 1225079346 |
|---|---|
| LBN Legal business name | Renner, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Sep 14th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225079346 | NPPES |
| Florida | MEDICAID | 273852000 |
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