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General NPI Number Information
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NPI Number | 1790210375
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Entity Type | Organization
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Legal Business Name | RDR OPTOMETRIC CARE, PA
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 3535 APALACHEE PKWY
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City | TALLAHASSEE
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State | FL
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Zip | 32311-5330
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Country | US
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Telephone | 850-219-0788
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Fax |
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Provider Business Mailing Address
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Address Line | 2213 GREYSTONE LN
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City | TALLAHASSEE
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State | FL
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Zip | 32312-6004
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Country | US
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Telephone | 786-546-4030
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. REBECCA DELMORAL RUDOLFER
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Credential |
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Telephone | 850-219-0788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC0003197
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License Number State | FL
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