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General NPI Number Information
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NPI Number | 1841608247
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Entity Type | Organization
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Legal Business Name | R&R RAPID RESPONSE PROFESSIONAL MEDIAL AGENCY LLC
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 40230 US HIGHWAY 27 N STE 140
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City | DAVENPORT
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State | FL
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Zip | 33837-2636
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Country | US
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Telephone | 863-353-2612
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Fax | 863-438-7928
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Provider Business Mailing Address
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Address Line | 40230 US HIGHWAY 27 N STE 140
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City | DAVENPORT
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State | FL
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Zip | 33837-2636
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Country | US
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Telephone | 863-353-2612
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Fax | 863-438-7928
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Authorized Official
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Title or Position | CEO
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Name | MS. GWENNETTE CARMELLA BODDIE
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Credential | RN
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Telephone | 863-353-2612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 1724
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License Number State | FL
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