| Doctor Name: | MR. RENATO WALMOR ROZA |
| NPI Number: | 1194779173 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA 9101365 |
| Business Practice Address: | 2900 Veterans Way Viera, FL - 329408007 |
| Business Phone Number: | 3216373625 |
| Business Fax Number: | 3216373619 |
| Mailing Address: | 1066 Citrus Ave Ne, PALM BAY |
| State: | FL |
| Postal Code: | 329054847 |
| Phone Number: | 3219517571 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA 9101365 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |