Provider Demographics
NPI:1033229257
Name:RENTE, ALBERTO L (OD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:L
Last Name:RENTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 W 49TH ST
Mailing Address - Street 2:SUITE 1486
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2957
Mailing Address - Country:US
Mailing Address - Phone:305-819-3134
Mailing Address - Fax:305-819-3107
Practice Address - Street 1:1665 W 49TH ST
Practice Address - Street 2:SUITE 1486
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2957
Practice Address - Country:US
Practice Address - Phone:305-819-3134
Practice Address - Fax:305-819-3107
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3979152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC3979OtherFLORIDA LICENSE
GAOPT2076OtherGEORGIA LICENSE
PR581OtherPUERTO RICO LICENSE
FLU96863Medicare UPIN