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Provider Information for 1477336055


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Mrs. MELISSA E RENTAS LMHC


Sex: Female

NPI: 1477336055
Last Updated: 2023-08-16
Certification Date: 2023-08-16

Details

NameValue
NPI1477336055
Enumeration Date2023-08-16
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 4830 W KENNEDY BLVD STE 600
TAMPA, FL 33609-2584
United States

Phone: 786-922-6036 | Fax:
 
Primary Practice Address 5850 SWEET WILLIAM TER
LAND O LAKES, FL 34639-2803
United States

Phone: 786-922-6036 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH22408