MEDICARE: RIVERLAND MEDICAL CENTERS, INC

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
1	261QM1300X	Multi-Specialty Clinic/Center		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396883807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERLAND MEDICAL CENTERS, INC

Provider Business Mailing Address
First Line	:	2774 DAVIE BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-2927
Country	:	US
Telephone Number	:	954-791-5184
Fax Number	:	954-791-3458

Provider Business Practice Location Address
First Line	:	2774 DAVIE BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-2927
Country	:	US
Telephone Number	:	954-791-5184
Fax Number	:	954-791-3458

Authorized Official
Title or Position	:	OWNER
Name	:	CAROLINA G LUNA
Credential	:
Telephone Number	:	954-612-0293

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	10/02/2024

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Directions to “RIVERLAND MEDICAL CENTERS, INC ” Practice Location

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