Angel L Rentas Leon, MD
Individual provider Active NPI General Practice Physician · Kissimmee, FL
NPI 1407092877 · NPPES record last updated Jul 31, 2023
Key facts
- NPI
- 1407092877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- ACN1542 (FL)
- Practice address
- 3372 W Southport Rd
Kissimmee, FL 34746-2706 - Phone
- (407) 933-7900
- Fax
- (321) 437-0072
- NPI assigned
- Jan 6, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6675 Westwood Blvd
Suite 475
Orlando, FL 32821-6027
Villa Esperanza
2 46
Ponce, PR 00716
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PR, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101122000849 | PR | Practitioner - General Practice | 0042406647 | Reassigns benefits to 2 organizations |
| I20230811000215 | FL | Practitioner - General Practice | 0042406647 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17427 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Medical Center Inc | General Practice | Current |
Accepting new patients |
| Medical Home Alliance LLC | Current |
Accepting new patients | |
| Primary Medical Center, Inc | Current |
Accepting new patients | |
| Primary Medical Group, C.S.P. | Current |
Accepting new patients | |
| Primary Medical Group,C.S.P. | General Practice | Current |
Accepting new patients |
| Medical Home Alliance LLC | Past | Accepting new patients |
Locations
3372 W Southport Rd
Kissimmee, FL 34746
Phone (407) 933-7900
3372 W Southport Rd
Ste A
Kissimmee, FL 34746
6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384
199 Avenue K SE
Winter Haven, FL 33880
Phone (563) 588-1424
607 Calle Ferrocarril
Ponce, PR 00717
Phone (787) 259-7219
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 17427 | PR | |
| General Practice Physician | 208D00000X | ACN1542 | FL | Yes |
Addresses
Primary practice location
3372 W Southport Rd
Kissimmee, FL 34746-2706
Mailing address
6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330
Other providers in Kissimmee, FL
- Renee Margarita Perocier, M.D
- Renewed Steps Therapy, LLC
- Joseph Raymond Renfort Jr.
- Renner Therapy LLC
- Mikaela Renner
- Eduardo Rentas Jr.
- Gianna Marisa Renteria
- Lizbet Resendiz
- Residential Care Homes LLC
- Resilva Companion Services, Inc
All providers in Kissimmee, FL · General Practice Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.