Healthcare Provider Details

I. General information

NPI: 1891791000
Provider Name (Legal Business Name): ANTONIO G RENTA MUNOZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date: 03/15/2006
Reactivation Date: 03/22/2006

III. Provider practice location address

AVE ROOSEVELT # 400 CLINICA LAS AMERICAS SUITE 203
HATO REY PR
00918-0000
US

IV. Provider business mailing address

PO BOX 362309
SAN JUAN PR
00936-2309
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-4450
  • Fax: 787-767-5003
Mailing address:
  • Phone: 787-767-4450
  • Fax: 787-767-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number8837
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: