Healthcare Provider Details

I. General information

NPI: 1841026101
Provider Name (Legal Business Name): R GROUP HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9103B SW 19TH PL
DAVIE FL
33324-5072
US

IV. Provider business mailing address

9103B SW 19TH PL
DAVIE FL
33324-5072
US

V. Phone/Fax

Practice location:
  • Phone: 305-742-7571
  • Fax:
Mailing address:
  • Phone: 305-742-7571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: IVORY J ROBINSON
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 305-742-7571