Provider Demographics
NPI:1467798207
Name:MAXWELL RENT MD. PA.
Entity Type:Organization
Organization Name:MAXWELL RENT MD. PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:RENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-847-0334
Mailing Address - Street 1:5425 WATER ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4030
Mailing Address - Country:US
Mailing Address - Phone:727-847-0334
Mailing Address - Fax:727-847-1779
Practice Address - Street 1:5425 WATER ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4030
Practice Address - Country:US
Practice Address - Phone:727-847-0334
Practice Address - Fax:727-847-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036837207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty