Provider Demographics
NPI:1932877917
Name:RENDA, VITTORIA MARIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VITTORIA
Middle Name:MARIA
Last Name:RENDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 CREST PINES DR APT 624
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7167
Mailing Address - Country:US
Mailing Address - Phone:772-408-2259
Mailing Address - Fax:
Practice Address - Street 1:4042 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4062
Practice Address - Country:US
Practice Address - Phone:407-277-4103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2008950OtherPK
FL109953100Medicaid