Provider Demographics
NPI:1942217229
Name:LENTO, PAUL H (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:LENTO
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 1:2750 BAHIA VISTA STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239
Mailing Address - Country:US
Mailing Address - Phone:941-951-2663
Mailing Address - Fax:215-707-3644
Practice Address - Street 1:2750 BAHIA VISTA STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-951-2663
Practice Address - Fax:215-707-3644
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-102338208100000X, 2081P2900X, 208VP0014X
PAMD-4330452081P2900X, 208100000X
FLME90421208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA597586OtherMEDICARE GROUP
ILP00052128OtherRAILROAD MEDICARE
PACD4829OtherRAILROAD MEDICARE
IL036102338Medicaid
ILP00052129OtherRAILROAD MEDICARE
PA597586OtherMEDICARE GROUP
ILL85262Medicare PIN
PACD4829OtherRAILROAD MEDICARE
H30390Medicare UPIN
ILK08702Medicare PIN