Healthcare Provider Details

I. General information

NPI: 1750816054
Provider Name (Legal Business Name): RPA HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 E 138TH AVE SUITE 7
TAMPA FL
33613-3904
US

IV. Provider business mailing address

703 HUXLEY PL
SUN CITY CENTER FL
33573-5427
US

V. Phone/Fax

Practice location:
  • Phone: 813-992-7867
  • Fax: 813-333-7335
Mailing address:
  • Phone: 813-992-7867
  • Fax: 813-333-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BERNARD O SPOONER
Title or Position: OWNER/ADMINISTRATOR
Credential: RN
Phone: 813-992-7867