MEDICARE: LIZBETH MARIE FRATICELLI RENTERO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	167008	FL
2	207R00000X	Internal Medicine Physician	ME167009	FL

General Provider Information

NPI Number	:	1295362283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIZBETH MARIE FRATICELLI RENTERO MD

Provider Business Mailing Address
First Line	:	9501 ANDERSON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1252
Country	:	US
Telephone Number	:	813-413-7333
Fax Number	:	813-563-4530

Provider Business Practice Location Address
First Line	:	9501 ANDERSON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1252
Country	:	US
Telephone Number	:	813-413-7333
Fax Number	:	813-563-4530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	03/05/2025

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