Healthcare Provider Details

I. General information

NPI: 1063400364
Provider Name (Legal Business Name): SONIA INES RENTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 SW 8TH ST SUITE 37
MIAMI FL
33174-2900
US

IV. Provider business mailing address

9600 SW 8TH ST SUITE 37
MIAMI FL
33174-2900
US

V. Phone/Fax

Practice location:
  • Phone: 305-553-4024
  • Fax: 305-553-4025
Mailing address:
  • Phone: 305-553-4024
  • Fax: 305-553-4025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME67738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: