MEDICARE: R&R MEDSPA AND WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QP3300X	Pain Clinic/Center
2	261QI0500X	Infusion Therapy Clinic/Center
3	261QP2300X	Primary Care Clinic/Center
4	207LP2900X	Pain Medicine (Anesthesiology) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9262454	OTHER	FL	FLORIDA

General Provider Information

NPI Number	:	1245195650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R&R MEDSPA AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	246 E COBB AVE
Second Line	:
City	:	CRESTVIEW
State	:	FL
Zip	:	32539-4212
Country	:	US
Telephone Number	:	850-598-9939
Fax Number	:

Provider Business Practice Location Address
First Line	:	246 E COBB AVE
Second Line	:
City	:	CRESTVIEW
State	:	FL
Zip	:	32539-4212
Country	:	US
Telephone Number	:	850-598-9939
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	NICHOLAS PATRICK REEDER
Credential	:	FNP, ARNP
Telephone Number	:	850-598-9939

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “R&R MEDSPA AND WELLNESS CENTER LLC ” Practice Location

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