Healthcare Provider Details

I. General information

NPI: 1902894587
Provider Name (Legal Business Name): RENATO V SARTORI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 AVE ARTERIAL HOSTOS SUITE 603
SAN JUAN PR
00918-1474
US

IV. Provider business mailing address

239 AVE ARTERIAL HOSTOS SUITE 603
SAN JUAN PR
00918-1474
US

V. Phone/Fax

Practice location:
  • Phone: 787-274-1717
  • Fax: 787-281-0815
Mailing address:
  • Phone: 787-274-1717
  • Fax: 787-281-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number003965
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number003965
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: