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NPI Code Detail

MEDICARE: RIDA RASOOL DO

MEDICARE: RIDA RASOOL DO
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS22658FL

General Provider Information

NPI Number : 1285364117
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIDA RASOOL DO
Provider Business Mailing Address
First Line : 20186 CORTEZ BLVD
Second Line :
City : BROOKSVILLE
State : FL
Zip : 34601-3832
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20186 CORTEZ BLVD
Second Line :
City : BROOKSVILLE
State : FL
Zip : 34601-3832
Country : US
Telephone Number : 352-835-5431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2022
Last Update Date : 03/03/2026

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Directions to “ RIDA RASOOL DO” Practice Location

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