Provider Demographics
NPI:1396750196
Name:ERIC J RENTZ PHYSICAL MEDICINE SERVICES PA
Entity type:Organization
Organization Name:ERIC J RENTZ PHYSICAL MEDICINE SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:RENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-371-1481
Mailing Address - Street 1:112 LEACROFT WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7757
Mailing Address - Country:US
Mailing Address - Phone:919-371-1481
Mailing Address - Fax:828-898-2452
Practice Address - Street 1:20800 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1147
Practice Address - Country:US
Practice Address - Phone:305-937-2281
Practice Address - Fax:305-937-2387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33926Medicare ID - Type Unspecified