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General NPI Number Information
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NPI Number | 1386754505
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Entity Type | Organization
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Legal Business Name | RENTE EYE SERVICES P A
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 1665 W 49TH ST STE 1486
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City | HIALEAH
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State | FL
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Zip | 33012-2957
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Country | US
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Telephone | 305-819-3134
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Fax | 305-819-3107
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Provider Business Mailing Address
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Address Line | 1665 W 49TH ST STE 1486
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City | HIALEAH
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State | FL
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Zip | 33012-2957
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Country | US
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Telephone | 305-819-3134
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Fax | 305-819-3107
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Authorized Official
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Title or Position | OWNER
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Name | ALBERTO L RENTE
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Credential | OD
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Telephone | 305-819-3134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3979
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License Number State | FL
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