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Individual

JESSICA LYNN RENTAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1200 LEXINGTON GREEN LN, SANFORD, FL 32771-1013
(407) 322-8404
Mailing address
2400 QUEENSWOOD CIR, KISSIMMEE, FL 34743-3411
(407) 973-9524

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 3445
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
686675
MEDICARE
Enumeration date
05/13/2013
Last updated
05/13/2013
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