Provider Demographics
NPI:1982564332
Name:RENTAS ADVANCE MEDICAL, LLC.
Entity type:Organization
Organization Name:RENTAS ADVANCE MEDICAL, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-565-7578
Mailing Address - Street 1:PO BOX 100192
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33910-0192
Mailing Address - Country:US
Mailing Address - Phone:239-565-7578
Mailing Address - Fax:941-621-0257
Practice Address - Street 1:627 CAPE CORAL PKWY W STE 209V
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6748
Practice Address - Country:US
Practice Address - Phone:239-565-7578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty