Provider Demographics
NPI:1699536748
Name:RENTZ, PAUL A (ARNP,)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:RENTZ
Suffix:
Gender:M
Credentials:ARNP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9341 SACRAMENTO DR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1648
Mailing Address - Country:US
Mailing Address - Phone:727-253-6839
Mailing Address - Fax:
Practice Address - Street 1:3543 LITTLE RD STE A
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1814
Practice Address - Country:US
Practice Address - Phone:727-848-6400
Practice Address - Fax:727-848-6200
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11029639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily