Provider Demographics
NPI:1578971826
Name:RIENZI, MARIA (PA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:RIENZI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PHYSICIANS REGIONAL MEDICAL GROUP
Mailing Address - Street 2:6101 PINE RIDGE RD
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:
Practice Address - Street 1:PHYSICIANS REGIONAL MEDICAL GROUP
Practice Address - Street 2:6101 PINE RIDGE RD
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108637363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical