Healthcare Provider Details

I. General information

NPI: 1346451432
Provider Name (Legal Business Name): RHEUMATOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 SE OCEAN BLVD STE 101
STUART FL
34996-3301
US

IV. Provider business mailing address

2220 SE OCEAN BLVD STE 101
STUART FL
34996-3301
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-8380
  • Fax: 772-283-5538
Mailing address:
  • Phone: 772-283-8380
  • Fax: 772-283-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number207RR0500X
License Number StateFL

VIII. Authorized Official

Name: DR. DARRELL N FISKE
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 772-283-8380