Provider Demographics
NPI:1932808904
Name:CHRISTELLE RENTA LLC
Entity Type:Organization
Organization Name:CHRISTELLE RENTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTELLE
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:RENTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-587-6406
Mailing Address - Street 1:15535 CITRUS HARVEST RD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9253
Mailing Address - Country:US
Mailing Address - Phone:407-587-6406
Mailing Address - Fax:760-313-9592
Practice Address - Street 1:141 TERRA MANGO LOOP STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-8510
Practice Address - Country:US
Practice Address - Phone:407-730-9027
Practice Address - Fax:760-313-9592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty