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NPI Code Detail

MEDICARE: RECHARGE LLC

MEDICARE: RECHARGE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QB0002XObesity Medicine (Family Medicine) Physician
2208D00000XGeneral Practice Physician
3207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1326680927
Entity Type Code : Organization
Provider Name (Legal Business Name) : RECHARGE LLC
Provider Business Mailing Address
First Line : 47 SW 17TH ST
Second Line :
City : OCALA
State : FL
Zip : 34471-8104
Country : US
Telephone Number : 352-512-9996
Fax Number :
Provider Business Practice Location Address
First Line : 47 SW 17TH ST
Second Line :
City : OCALA
State : FL
Zip : 34471-8104
Country : US
Telephone Number : 352-512-9996
Fax Number : 866-622-5714
Authorized Official
Title or Position : DOCTOR
Name : STEVEN TIECHE
Credential : MD
Telephone Number : 352-512-9996
Provider Enumeration Date : 10/15/2019
Last Update Date : 10/15/2019

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1962198994 — RHONDA OGLESBY
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Directions to “RECHARGE LLC ” Practice Location

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