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NPI Code Detail

MEDICARE: RDR OPTOMETRIC CARE, PA

MEDICARE: RDR OPTOMETRIC CARE, PA
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
1152W00000XOptometristOPC0003197FL

General Provider Information

NPI Number : 1790210375
Entity Type Code : Organization
Provider Name (Legal Business Name) : RDR OPTOMETRIC CARE, PA
Provider Business Mailing Address
First Line : 2213 GREYSTONE LN
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32312-6004
Country : US
Telephone Number : 786-546-4030
Fax Number :
Provider Business Practice Location Address
First Line : 3535 APALACHEE PKWY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32311-5330
Country : US
Telephone Number : 850-219-0788
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST/OWNER
Name : DR. REBECCA DELMORAL RUDOLFER
Credential :
Telephone Number : 850-219-0788
Provider Enumeration Date : 04/20/2017
Last Update Date : 04/20/2017

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Directions to “RDR OPTOMETRIC CARE, PA ” Practice Location

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