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General NPI Number Information
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NPI Number | 1992045868
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Entity Type | Organization
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Legal Business Name | R&R LLC
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 1953 S CLUB DR
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City | WELLINGTON
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State | FL
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Zip | 33414-9092
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Country | US
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Telephone | 561-389-3503
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Fax | 561-795-7009
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Provider Business Mailing Address
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Address Line | 14097 LILY CT
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City | WELLINGTON
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State | FL
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Zip | 33414-8631
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Country | US
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Telephone | 561-389-3503
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Fax | 561-795-7009
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | RICARDO NELSON GUTIERREZ
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Credential |
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Telephone | 561-389-3503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11795
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License Number State | FL
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