Healthcare Provider Details

I. General information

NPI: 1467015578
Provider Name (Legal Business Name): RCSL NAPLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 N HESPERIDES ST
TAMPA FL
33614-5414
US

IV. Provider business mailing address

5510 N HESPERIDES ST
TAMPA FL
33614-5414
US

V. Phone/Fax

Practice location:
  • Phone: 727-418-2567
  • Fax:
Mailing address:
  • Phone: 727-418-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN LOMONICO
Title or Position: PRESIDENT
Credential:
Phone: 727-418-2567