Provider Demographics
NPI:1194691568
Name:RENTAS ADVANCE MEDICAL, LLC.
Entity type:Organization
Organization Name:RENTAS ADVANCE MEDICAL, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RENTAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:239-677-0673
Mailing Address - Street 1:715 SW 11TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:239-673-1711
Practice Address - Street 1:715 SW 11TH CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2148
Practice Address - Country:US
Practice Address - Phone:239-677-0673
Practice Address - Fax:239-673-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty