Provider Demographics
NPI:1477510741
Name:RENT, MAXWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:MAXWELL
Middle Name:
Last Name:RENT
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 1:5425 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:727-847-0486
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:727-847-0486
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036837207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062170600Medicaid
FL51130Medicare ID - Type Unspecified
FL51130Medicare UPIN