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General NPI Number Information
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NPI Number | 1205310612
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Entity Type | Organization
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Legal Business Name | RAG ARNP SERVICE CORP
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 1470 NW 107TH AVE STE G
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City | SWEETWATER
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State | FL
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Zip | 33172-2734
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Country | US
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Telephone | 305-594-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 17733 SW 146TH CT
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City | MIAMI
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State | FL
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Zip | 33177-7668
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Country | US
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Telephone | 754-423-1825
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS ROBERTO ALVAREZ GARCIA
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Credential | ARNP
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Telephone | 754-423-1825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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