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General NPI Number Information
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NPI Number | 1578731709
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Entity Type | Organization
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Legal Business Name | RTG MEDICAL
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 10354 SMOOTH WATER DR 186
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City | HUDSON
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State | FL
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Zip | 34667-8804
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Country | US
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Telephone | 727-869-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 10354 SMOOTH WATER DR 186
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City | HUDSON
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State | FL
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Zip | 34667-8804
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Country | US
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Telephone | 727-869-0053
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MS. JANET LEE TOMPKIN
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Credential | NURSE
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Telephone | 727-869-0053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5156377
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License Number State | FL
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