Healthcare Provider Details

I. General information

NPI: 1093023400
Provider Name (Legal Business Name): R&R INTERNAL MEDICINE SPECIALIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 POINTVIEW CT
ORLANDO FL
32836-6300
US

IV. Provider business mailing address

PO BOX 618189
ORLANDO FL
32861-8189
US

V. Phone/Fax

Practice location:
  • Phone: 786-375-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME95352
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME89166
License Number StateFL

VIII. Authorized Official

Name: JOSE RAMON
Title or Position: MGRM
Credential:
Phone: 786-375-1500