Individual
DAISY RENTERIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4930 E LAKE MARY BLVD, SANFORD, FL 32771-5003
(407) 322-8645
Mailing address
4930 E LAKE MARY BLVD, SANFORD, FL 32771-5003
(407) 322-8645
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
FL
Other
Enumeration date
06/14/2021
Last updated
06/30/2022
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