OrganizationRenaissance Medical Center CorpGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address3832 W Humphrey St, Tampa, FL 33614-1955(813) 440-4420PECOS EnrollmentBased on the most recent information from CMS, provider Renaissance Medical Center Corp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1437691169Provider TypeOrganizationFull NameRenaissance Medical Center CorpSubpartNoEnumeration Date11/11/2016Last Updated6/5/2023Contact InformationPractice LocationPractice Address3832 W Humphrey St, Tampa, FL 33614-1955Phone(813) 440-4420Fax(813) 502-0290Mailing LocationMailing Address3832 W Humphrey St, Tampa, FL 33614-1955Phone(813) 440-4420Fax(813) 502-0290Authorized OfficialNameLominchar, Amilcar M (Md/Owner)Phone(813) 440-4420Provider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode261Q00000XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseME125313Florida