Provider Demographics
NPI:1487207247
Name:RENTAS, ANGEL JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:JAVIER
Last Name:RENTAS
Suffix:
Gender:M
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:URB VILLA ESPERANZA
Mailing Address - Street 2:46 CALLE 2
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-246-3390
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA ESPERANZA
Practice Address - Street 2:46 CALLE 2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-246-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21494208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice