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General NPI Number Information
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NPI Number | 1407054851
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Entity Type | Individual
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Provider Name | MATTHEW RENSBERRY MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 1850 LEE RD STE 134
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City | WINTER PARK
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State | FL
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Zip | 32789-2104
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Country | US
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Telephone | 407-634-1690
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Fax | 407-369-4236
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Provider Business Mailing Address
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Address Line | 1850 LEE RD STE 134
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City | WINTER PARK
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State | FL
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Zip | 32789-2104
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Country | US
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Telephone | 407-634-1690
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Fax | 407-369-4236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME117525
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01066107A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | ME117525
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License Number State | FL
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