Provider Demographics
NPI:1407092877
Name:RENTAS LEON, ANGEL L (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:L
Last Name:RENTAS LEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 WESTWOOD BLVD STE 475
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6027
Mailing Address - Country:US
Mailing Address - Phone:407-845-0330
Mailing Address - Fax:888-972-1750
Practice Address - Street 1:3372 W SOUTHPORT RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-2706
Practice Address - Country:US
Practice Address - Phone:407-933-7900
Practice Address - Fax:321-437-0072
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17427208D00000X
FLACN1542208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice