Provider Demographics
NPI:1063400364
Name:RENTE, SONIA INES (MD)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:INES
Last Name:RENTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 SW 8TH ST
Mailing Address - Street 2:SUITE 37
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2900
Mailing Address - Country:US
Mailing Address - Phone:305-553-4024
Mailing Address - Fax:305-553-4025
Practice Address - Street 1:9600 SW 8TH ST
Practice Address - Street 2:SUITE 37
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2900
Practice Address - Country:US
Practice Address - Phone:305-553-4024
Practice Address - Fax:305-553-4025
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67738208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
26605Medicare ID - Type Unspecified
G05860Medicare UPIN