Healthcare Provider Details

I. General information

NPI: 1699167783
Provider Name (Legal Business Name): RITECARE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 W 49TH ST
HIALEAH FL
33012-3412
US

IV. Provider business mailing address

915 W 49TH ST
HIALEAH FL
33012-3412
US

V. Phone/Fax

Practice location:
  • Phone: 305-200-1225
  • Fax: 305-200-1183
Mailing address:
  • Phone: 415-200-2099
  • Fax: 888-972-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GIANNA PAPA
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 617-894-1718