MEDICARE: RICE MEDICAL SERVICES LLC

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	103TH0100X	Health Service Psychologist

General Provider Information

NPI Number	:	1790668820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICE MEDICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	11045 SW 216TH ST UNIT 1
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33170-3073
Country	:	US
Telephone Number	:	305-795-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	692 NW PLACID AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-1012
Country	:	US
Telephone Number	:	305-795-0600
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAURICIO GARCIA LOSADA
Credential	:
Telephone Number	:	305-795-0600

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	09/10/2025

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