Healthcare Provider Details

I. General information

NPI: 1134477326
Provider Name (Legal Business Name): RMA MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 WEST OAKLAND PARK BLVD SUITE E214
SUNRISE FL
33351
US

IV. Provider business mailing address

7800 WEST OAKLAND PARK BLVD SUITE E214
SUNRISE FL
33351
US

V. Phone/Fax

Practice location:
  • Phone: 954-318-6590
  • Fax: 954-318-6604
Mailing address:
  • Phone: 954-318-6590
  • Fax: 954-318-6604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF DUDLEY
Title or Position: COO
Credential:
Phone: 954-318-6590